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1 A**-. 



YOUNG MOTHERS 



PHYSICAL EDUCATION 



CHILDREN 



BY A GRANDMOTHER. 



FIRST AMERICAN EDITION, WITH ADDITIONS. 






BOSTON: 

MILLIARD, GRAY, AND CO 
1833. 









Massachusetts. 



R E E M A N i->D BOLLES. 






si 



ADVERTISEMENT TO THE AMERICAN EDITION. 



This little Treatise, of which an edition is now 
for the first time offered to the American public, 
has already been partially known in this country, 
and has received the approbation of some of our 
most eminent physicians. Its object is a very 
important one, and is treated in a sensible and 
judicious manner. The directions given, may in 
some instances appear to the inexperienced too 
minute, and even frivolous; but the importance 
of attending carefully to trifles which affect the 
welfare of her children, will be readily admitted 
by every mother. 

That it is not intended to interfere with the 
province of the physician, is obvious from the re- 
peated directions in the course of the book to 
apply early for medical advice, before disease 
becomes seated. 

The Editor has revised the work carefully, and 
made such alterations and omissions as seemed 
necessary; has added one entire chapter, and 
trusts that the labor bestowed on it will not be 
thought altogctber useless. 
Bosto.v, June, 1833. 



PREFACE. 



This book is really what it professes to be — the work 
of an old ivoman. In fact no other description of per- 
son would have been equal to the undertaking ; which, 
humble as it is, required a peculiar combination of 
circumstances to insure any prospect of success : and 
as those old women who have leisure to write, have 
not always opportunities of obtaining the experience 
of a nurse, or inclination to study the writings of med- 
ical men, the author has thought it expedient to attempt 
a work of real utility, for which, perhaps, few others 
possess the necessary qualifications. 

Having suckled many children, she has had means 
of obtaining, from the first source, a species of knowl- 
edge which professional men can derive only from the 
information of women ; and by having read with atten- 
tion most of the best books which have been written 
on the management of children, she has convinced 
herself that the subject has not been exhausted. 

The object of this work is chiefly to instruct young 
mothers how to prevent, rather than to cure the diseases 
of children : for when maladies assume a dangerous 
form, and require medical treatment, the study of years 
is necessary to apply it with advantage. When, at 
some future time, the progress of science shall have 
simplified the art of healing, to the general advantage 
of mankind, the preventive part of medicine will pro- 



bably be considered as the most important ; and in con- 
sequence, the number of maladies be diminished. 

Long experience, and much observation, have induced 
the author of this work to believe, that a great number 
of the diseases which afflict the human race are effects 
of imprudence and neglect in the early part of life ; 
and that by constant and judicious attention to the 
physical education, during the first fifteen years, many 
of these diseases might be avoided. For this reason 
she is anxious to diffuse, amongst her own sex, a spe- 
cies of knowledge which may enable mothers to edu- 
cate their children with better prospects ef health and 
happiness ; and perhaps occasion them to take a greater 
interest in the welfare of their offspring, !>y proving how 
much it depends OH their attention. 

The disadvantages under which a medical man labors 
in his attendance on infant patients, are many, and may 
be ascribed to various causes ; but the greatest is the 
difficulty of obtaining accurate information from the 
sick, who arc incapable of describing their sensations, 
and when the principal lights arc to be received from 
some person totally ignorant of the science of medicine. 
This often renders the task of prescribing for the diseases 
of children a matter of great difficulty : ami the indiscre- 
tion of their attendants frequently counteracts the good 
effects of the most judicious advice. 

Even where a physician, by being the father of a 
numerous offspring, may appear to have had the best 
means of studying those maladies incident to the early 
yean of man, it is impossible he should ever have such 
experience of the momentary changes to which the 
infant frame is liable, as may be acquired by an observ- 
ing mother or an attentive nurse ; and which, were it 
combined with a moderate degree of scientific know- 
ledge, would often prove the surest guide to the medical 



attendant. But it too frequently happens that, through 
the ignorance of those about them, the complaints of 
children are at first disregarded ; palliative remedies are 
neglected, and the professional man is not sought for 
until it is too late. In truth, no appearance of indis- 
position in a child should ever be thought trifling ; and 
though the greater number may not require the assist- 
ance of medicine, yet, in those that do, it should be 
resorted to without delay. It is to little purpose that a 
physician is consulted when the vital powers have been 
exhausted by the continuance of disease ; and still less 
when only a part of his advice is followed. Such is 
often the consequence of that sort of ignorance, which 
it is the object of this work to diminish. 

When the best physicians are surrounded with diffi- 
culties in their treatment of the maladies to which 
infants are subject, it is not surprising that many child 
ren are lost through the want of a little more know- 
ledge in the women who are constantly about them 
Various indispositions are brought on or increased by 
neglect ; and the timely application of simple remedies 
would often check the progress of maladies which 
become dangerous through inattention. 

It sometimes happens that a long series of years 
spent in the service of children, may have given to an 
old nurse a degree of experience, which, if accompa- 
nied with discretion and modesty, would be of infinite 
value ; but, unfortunately, it is usually attended with 
the inconvenience of her fancying herself capable of 
prescribing medicines with the nature and force of 
which she is unacquainted, and which, if improperly 
administered, may occasion the most pernicious effects. 
The courage of ignorance is always great ; the mistakes 
resulting from it often fatal; and it frequently happens 
(both in regard to children and adults) that, in cases 



where the learned and judicious physician considers it 
prudent to delay his exertions, an ignorant apothecary 
or officious nurse, will throw in medicine upon medi- 
cine ; and, by disturbing the salutary efforts of nature, 
augment the disease, perhaps to the destruction of the 
patient. 

The excessive ignorance of the generality of man- 
kind respecting every thing which relates to medicine, 
is productive of many bad consequences ; one of which 
(and not the least) is the power it bestows on a tribe of 
ignorant pretenders, who infest the earth, to the great 
detriment of the sick: for few persons know how to 
distinguish between them and those men whi . d( diea- 
ting their time and talents to the researches of science, 
are enabled to relieve the infirmities of human nature. 
To choose a physician well, one should be half a phy- 
sician one's self : butnstbisi, i \ ithmany, 
the best plan which the mother of a family can adopt 
i- to select a man whose education has been suitable to 
his profession ; whose habits of life are such as prove 
that be continues to acquire both pra tical and thco- 
. i knowledge; who is neither a bigot in old opin- 
ions, nor an enthusiast in new. A little attention in 
making the necessary inquiries, will suffice to ascertain 
the requisites here specified ; to which should be added 
(what is usually found in medical men of real m< rit,) 
those qualities which may serve to render him an 
agreeable companion : for the family physician sliould 
always be the family friend. 

Though the design of this work has been merely to 
treat of physical education, a subject which has been 
much less discussed than moral, yet, the strict connexion 
between mind and body has render, d it impossible to 
enter fully into the former without touching on the 
latter : and it is hoped that what has been said of the 



moral part of education will not be considered as alto- 
gether useless . 

The great influence which the conduct of a mother, 
during the time of pregnancy and nursing, is likely to 
have on the health of her offspring, has induced the 
author to prefix some introductory advice on those 
subjects ; which may possibly be advantageous to the 
inexperienced, and cannot appear misplaced in a work 
of this nature. 

In these pages will probably be found many known 
truths and many old remarks : but let it be remembered 
that the task was undertaken wholly with a view to 
utility, and not to disseminate new opinions, or to dis- 
play the learning of the author ; whose object, in fact, 
has been to write such a book as she would herself, at 
the age of twenty, have received as a valuable gift. 
Technical terms have been avoided as much as possible, 
and few medicines recommended ; for when many are 
.supposed to be necessary, the opinion of a professional 
man must be required. 

The observations and advice contained in this work 
are chiefly the result of the author's own experience 
and when they are founded on the information of 
others, that information has been examined with the 
strictest attention. The book is the production of many 
years' study and reflection ; and the author cannot 
help flattering herself that it will be of some use to 
those for whom it is designed, — the anxious mother, 
the attentive governess, and the careful nurse. 



CONTENTS. 



INTRODUCTION. 

Chapter I. Pa ^ e 

On pregnancy and child-birth ... 17 

Chap. II. 

On the duties of nurses 25 

Chap. III. 

On nursing 31 

PART THE FIRST. 
treatment of infants from their birth till af- 
ter two months old, and the maladies to 
which they are liable during that period. 
Chap .1. 
Manner in which a new-born infant should be wash- 
ed and dressed— Wooden bathing vessel — Cush- 
ion stuffed with chopped straw — No pins in the 

clothes — First shifts 51 

Chap. II. 
Cleanliness — Excoriations — Washing the mouth 
— Flannel — Night-dress — Caps — Time of 
washing — Of dressing .... 58 

Chap. III. 
Modes of Cleanliness — Of sleeping — Cradle — 
Care of sight, and of all the senses . . 63 



Chap. IV. 
Rooms inhabited by infants — Manner of holding 
them — Of giving them fresh air ... 68 
Chap. V. 
Infants ought to have the mother's milk as soon as 
possible — Medicine seldom necessary — Want 
of appetite — Mucus in the stomach — Handling 
gently — How the head should be cleaned . 72 
Chap. VI. 
Internal pains — Crying — Costivcness — Stran- 
gury — Becoming thin — Distortions of face 78 
Chap. VII. 
Jaundice — Red gum — Hiccough — Looseness — 

Gripes 82 

Chap. VIII. 
Cold in the head — Sore eyes — Coughs and Colds 
— Accidental sore mouth — Thrush . . 87 
Chap. IX. 
( Convulsions — their various causes, and the manner 

of treating them !l * 

Chaj>. -\. 
Bringing up children without human milk 

Chap. XI. 
Hints respecting hired nurses .... 105 

PART THE SECOND. 

MANAGEMENT OF CHILDREN' FROM TWO MONTHS TO 
TWO YEARS OLD. 

Chap. I. 
Manner of making children hardy — Clothing — 
Shoes — Exercise 109 

Chap. II. 
Learning to walk — Bathing .... "4 



CONTENTS. Xiii 

Chap. III. 
Teeth — often irregular in time and order — 
Diarrhoea — Dysentery .... 117 

Chap. IV. 
Vomiting — Pain before the teeth appear — Hard 
substances unsuitable to the gums — Lancing the 
gums — Bleeding — Blistering . . . 121 
Chap. V. 
Advantages of air and exercise — Bowels to be kept 
open — How to treat spasmodic symptoms — 

Eruptions 126 

Chap. VI. 
Weaning, how to be effected with ease — What 
food proper for children — Necessary cautions 131 
Chap. VII. 
Variety of food proper for children under two years 
old — Sugar 137 

PART THE THIRD. 

TREATMENT OF CHILDREN AFTER TWO TEARS OLD. 

Chap. I. 
Diet — Regular hours of eating — Fruit — Evacua- 
tions — Bed-rooms 141 

Chap. II. 
Pulse — Feverishness — Slight diarrhoea — Double 
teeth — Irregular growth .... 147 
Chap. III. 
The heads of children should be kept cool — Run- 
ning at the nose not to be disregarded — Short 
hair — Bad habits — Dangerous tricks — Damp 

shoes. 152 

Chap. IV. 
Cleanliness — Cold bathing — Cold drink — Slight 
indispositions — Precautions . . . 158 



XIV CONTENTS. 

Chap. V. 
Chopped lips — Chilblains — Slight burns — Bruises 

— Wounds 165 

Chap. VI. 
Cautions respecting the treatment of girls at a 
critical time of life 175 

PART THE FOURTH 

OF DISEASES COMMON TO CHILDREN OF ALL AGES. 

Chap. I. 
Division of diseases — Fevers . . . 180 

Chap. II. 

Intermitting fevers or agues .... 184 

Chap. III. 

Eruptive fevers 187 

Chap. JV. 

Small-pox — Cow-pox 180 

Chap. V. 

Meazlcs 195 

Chap. VI. 
Scarlet fever — Slighter maladies of the same na- 
ture 204 

Chap VII. 

Colds and coughs 210 

Chap. VIII. 

Hooping-cough 215 

Chap. IX. 

Sore-throats 221 

Chap. X. 

The croup 225 

Chap. XI. 
The mumps 229 



CONTENTS. XV 

Chap. XII. 
Diarrhoea — Dysentery — Cholera morbus . 230 

Chap. XIII. 
Hydrocephalus, or water on the brain . . 241 

Chap. XIV. 
Convulsions ....... 245 

Chap. XV. 
Worms 252 

Chap. XVI. 
Scrofula 263 

Chap. XVII. 
Rickets 274 

Chap. XVIII. 
Cutaneous diseases . . . . . 279 

PART THE FIFTH. 

GENERAL OBSERVATIONS RESPECTING CHILDREN OF 
ALL AGES. 

Chap. I. 
Food — Purification of water — Children should 
not be pressed to eat — Irregularity of appetite — 
Sweet things — Children naturally gluttons — Do 
not require food in inflammatory diseases . 286 
Chap. II. 
Clothing — Covering the bosom and arms — Or- 
naments injurious to health — Beauty to be ac- 
quired — Ligatures of all sorts bad . . 292 
Chap. III. 
Evacuations — Exercise — Amusements — Warmth 

Change of air 298 

Chap IV. 
Heat of rooms — Crookedness — Round shoulders 
— Unwholesome postures — Sleep — Beds — 
Nocturnal terrors . . 306 



Chap. V. 
Painted toys — Independence — Praise — Wonder- 
ful children — Indolence — Deformed or discon- 
tented persons should not be about children 313 
Chap. VI. 
Sensibility — Jealousy — Punishments — Courage 

— Peevishness 310 

Chap. VII. 
Praise — Forgiveness — Religion — Learning — 

Accomplishments 328 

Chap. VIII. 
Physicians — Medicines — Treatment of children 
when ill — Conclusion .... 334 
APPENDIX. 
List of medicines, and some necessary directions 334 



INTRODUCTION. 



CHAPTER I. 

ON PREGNANCY AND CHILDBIRTH. 

A pregnant woman, who desires to produce 
an offspring, well constituted in body and mind, 
should pay the strictest attention to her own con- 
duct, both physical and moral. She should care- 
fully avoid any species of excess, and endeavor 
to keep her mind in the greatest tranquillity: she 
should contrive to have agreeable occupations, to 
enjoy the fresh air,%nd to take regular and mod- 
erate exercise; and she should, also, indulge the 
caprices of pregnancy, though not in too great a 
degree. A peculiar state of the stomach may 
enable it to digest a certain portion of apparently 
unwholesome food, but it is always imprudent, 
and sometimes dangerous, to yield entirely, even 
to what appears an instinct of nature, when na- 
ture deviates from the common track. 

Food taken more frequently, and in smaller 
quantities than at other times, would (in many 
1 



18 OX PREGNANCY AND CHILDBIRTH. 

cases) diminish that uneasiness of stomach which 
seems to belong to the first months of pregnancy, 
and which might often, be rendered scarcely per- 
ceptible by proper attention to the state of the 
bowels. Women of a costive habit of body, gen- 
erally suffer more from what is called the breed- 
ing sickness, than those of a contrary constitution; 
and such should therefore have recourse to the 
aid of medicine; which, it is scarcely necessary 
to say, should be of the mildest sort. Bleeding 
is also sometimes requisite, and many women are 
taught to believe it so much so, that if they have 
had occasion for it in the first, the same necessity 
will occur in every succeeding pregnancy; but 
this is a false, and may often prove an injurious 
opinion. Were more judicious arrangements made 
respecting diet and exercise, it is probable that 
all these artificial aids might generally be dispens- 
ed with. If a pregnant woman eats a great 
quantity of animal food, drinks fermented liquors 
111 abundance, and leads a sedentary life, her 
situation will naturally produce an extraordinary 
fulness of the blood-vessels, and incur the neces- 
sity of bleeding and other medical aid: but to one 
who eats moderately of meat, vegetables, fruit, 
Stc, drinks chiefly water, and takes exercise, 
(especially on foot) every day, for her amusement, 
such assistance will probably be unnecessary. 

Loose and light clothing is, also, of the greatest 
importance to the well-being of both the mother 
and the child, and numerous instances are on 
record of the pernicious consequences of tight 



ON PREGNANCY AND CHILDBIRTH 19 

lacing during the time of pregnancy. And here 
I cannot help remarking, that this species of self- 
torture, frequently, (perhaps I might say always,) 
fails of the desired effect; for when nature has 
determined that a woman shall retain in part that 
increase of bulk occasioned by pregnancy, which 
it is the object of tight stays to prevent, nothing 
will protect her from it. Indeed, were I to judge 
from my own observation, I should say that this 
unnatural practice was likely to occasion the defect 
(if such it may be called) which it was intended to 
prevent, as all those women whom I have known 
to be most eager in taking this precaution, have 
been disappointed in their hopes; while others, 
who have never thought on the subject, but fol- 
lowed the simple dictates of nature, and consulted 
only their own convenience, remain perfectly 
free from the dreaded augmentation after having 
brought forth ten or twelve children. 

In general, the whole business of labor is too 
much hurried. The slow and gradual operations 
of nature are not sufficiently respected: the fe- 
males who are present, urge the sufferer to " help 
herself," and the unnecessary and useless efforts 
she is thus induced to make, only tend to debili- 
tate her and her offspring. If women did but 
know something more of the animal economy, 
they would patiently submit to a little longer suf- 
fering, rather than run the risks attendant on 
making too great exertions, or receiving too much 
assistance. But in this, as in a thousand other 
instances, people run into fatal errors by allowing 
art to usurp the place of nature. 



20 ON PREGNANCY AND CHILDBIRTH. 

When a labor is tedious, the woman requires 
nourishment ; and this should be proportioned to 
that which she has been accustomed to take. 
One who is in the habit of drinking wine and 
fermented liquors may without danger apply to 
their aid during the time of labor: remembering, 
however, that the quantities should be less than 
she has been used to take at other times. But if 
a woman, who has always lived abstemiously, 
should be plied with heavy nourishment in this 
situation, the consequences might be extremely 
dangerous. 

Another great source of evil, is the prejudice 
common amongst women, that they must be in 
great danger as long as the after-birth remains 
in the womb; and, for this reason, the expulsion 
is seldom left to nature, which in most cases 
would require no artificial aid to bring away either 
the child, or its appendages. The common ex- 
pression, "is she tiiit'c yet?" to demand whether 
the after-birth has been expelled, clearly shows 
the vulgar opinion on this subject; i. e. that the 
woman is in danger of dying while it is retained. 
It is unnecessary to point out what must be the 
situation of a woman impressed with this idea, as 
long as this substance remains within her, which, 
if left to nature, it would often do for several 
hours without any injury, but the contrary. The 
instructed assistant, (whether male or female,) is 
well acquainted with the circumstances which 
render it necessary to extract the placenta by 
force; and, where there are not these indications, 



ON PREGNANCY AND CHILDBIRTH. 21 

it is better to trust to nature. At all events, the 
ignorant should refrain from interfering with, or 
hurrying those who have studied their profession. 
But this is one of the many cases in which every 
gossip thinks she has a right to give her opinion 
and advice. Constitutions differ so much that 
there can be no general rule to judge by. To 
one woman it may be natural to expel the after- 
birth in five minutes, to another in five hours, 
after the birth of the child; and the premature 
extraction, even when not attended with danger, 
is usually followed by severe afterpains and un- 
necessary loss of blood. 

Another injurious custom, which produces sim- 
ilar effects with the last mentioned, is that of 
changing all the clothes too soon after delivery. 
Matters should be so contrived, that the linen ne- 
cessary to be removed immediately, may be taken 
away without raising up or disturbing the body 
of the woman; and any further changes of cloth- 
ing should be deferred for several hours, until 
she may have taken nourishment and repose. 

In urging the necessity of avoiding fatigue, I 
only repeat what is continually recommended by 
medical writers; but, as this book is intended for 
those who do not peruse their works, I think it 
requisite to enforce the greatest attention to this 
subject. No one should be with a woman in la- 
bor but the necessary assistants, unless she her- 
self should express a particular desire to the 
contrary: her wish, of course, should be indulged; 
and, as it is not likely to extend to many persons, 



22 ON PREGNANCY AND CHILDBIRTH. 

it cannot produce the bad consequences resulting 
from a number of unnecessary spectators. After 
the pains of labor are over, the utmost tranquillity 
is necessary; and care should be taken that the 
visits of relations and intimates, too soon after 
delivery, do not occasion some dangerous altera- 
tion. Many women have been thrown into the 
most perilous situations merely by tedious and 
fatiguing attentions of this sort; and I have my- 
self known instances of some who have narrowly 
escaped with their lives. In general, silence, 
solitude and darkness, for the first eight-and-forty 
hours, are advantageous, if not absolutely neces- 
sary: and the mind of a woman, who has happily 
borne a promising child, is not liable to become 
melancholy for want of society. 

It is natural for a healthy woman to feel an 
extraordinary desire for frequent nourishment dur- 
ing the first two or three days after delivery; but 
she should be very cautious as to the quality of her 
food for the first week, that she may escape, or 
more easily pass through that inflammatory state, 
commonly called the milk fever. I say nothing 
of the quantity, which is usually the more impor- 
tant consideration, because the quality, for the 
first few days, should be of a sort not likely to 
occasion an excess in eating; and after that time 
the desire for food is not so keen. 

A woman of a good constitution, who suckles 
her child, will not require savory dishes or fer- 
mented liquors to give her an appetite, nor will 
she be likely to have occasion for medicine dur- 



ON PREGNANCY AND CHILDBIRTH. 23 

ing the time of her confinement. It may how- 
ever sometimes happen, that in consequence of 
remaining in bed, (and even the strongest women 
should be cautious not to leave it too soon, es- 
pecially in cold weather,) some assistance to the 
bowels may be required during the first week or 
fortnight: and in this case it would be far better 
to employ a simple clyster,* which acts only on 
the parts that want it, than derange the stomach 
by having recourse to purgative medicines. When 
the work of digestion goes on well, why do any 
thing that may disturb it? And if the lower 
bowels, from being accidentally over-heated, do 
not perform their functions properly, why not 
apply the remedy to the part which requires it? 
A clyster relieves the overloaded bowels without 
offending the stomach, which is a part of the 
human body the most important, and which re- 
quires to be treated with the greatest respect. 

What I have said in regard to the little neces- 
sity for medicine, refers only to the state of those 
women who follow the dictates of nature in ad- 
ministering to their offspring the food that Provi- 
dence has destined for them. Those who are 
either so unfortunate as not to be able, or so un- 
natural as not to be willing to suckle their children, 

* A form of syringe is now invented, with which persons 
are enabled to administer an injection to themselves, with- 
out assistance and with very little fatigue. This will, it is 
hoped, be a means of bringing into more general practice 
the use of a remedy which has hitherto been too much 
neglected in this country. Am. Ed. 



24 ON PREGNANCY AND CHILDBIRTH. 

must be treated as persons in a state of induced 
malady ; and accordingly have recourse to the aid 
of physicians and apothecaries. 

I cannot leave this subject entirely without 
saying a few words on the unnecessary pain to 
which women in labor are frequently exposed, 
when they are obliged to lie for hours on one 
side, a thing sufficiently disagreeable at anytime, 
but particularly irksome when some pain produces 
a desire to vary the posture. I cannot think that 
accoucheurs would enforce this law, if their pa- 
tients had courage to remonstrate: but as no one, 
who has not borne children, can be aware of the 
great difference between one position and another 
in this excrutiating state, it cannot be expected 
that professional men will make any change in 
established customs, unless induced by the rep- 
resentations of those whose sufferings they wish 
to alleviate. 

The reasons assigned for this dreadful rule of 
making women lie on the left side during the 
time of delivery, are by no means unanswerable; 
and in other countries, where it does not exist, 
the accidents it is alleged to prevent, do not occur 
more frequently than in the British isles. It ap- 
pears to me of great importance that all unneces- 
sary inconveniences should be avoided, as pro- 
ductive of additional irritation, and therefore 
inclining to fever after the actual pains of child- 
birth are at an end ; and that the persons about a 
woman in labor should not consider the present 
moment alone, but always look to the conse- 



THE DUTIES OF NURSES. 25 

quences after delivery, especially when the mo- 
ther is not destined to nourish her offspring ac- 
cording to the dictates of nature. 



CHAPTER II. 



THE DUTIES OF NURSES. 



It is much to be regretted that so little has 
been done with a view to qualifying persons to 
wait on the sick. The prescription of medicine 
and diet belongs to the physician; the adminis- 
tration of them is committed to the nurse; her 
qualifications therefore should be great, to be en- 
trusted with such a charge, as on her, the life of 
the patient may depend. How few are qualified 
need not be told, especially at their commence- 
ment. It may therefore be useful in a work of 
this kind, to say something on the duties of the 
nurse to whose immediate care both the mother 
and the child are in a great degree consigned. 
There are, no doubt in every city, worthy per- 
sons, who by experience have rendered themselves 
capable of discharging their duty, and who are in 
every respect deserving of public confidence. 
Those are generally employed by the rich, while 
persons of another class, though requiring the 
same care and attention, are frequently under the 
necessity of entrusting themselves and children 



26 THE DUTIES OF NURSES. 

to the care of those by no means qualified for 
this office, and it is not to be expected that the 
young mother will always have an accurate 
knowledge of the treatment she ought to receive 
from her nurse ; therefore many are the dangers 
to which she is exposed from inexperience on 
the one hand, and officious ignorance on the 
other. That this may in some degree be pre- 
vented, I have ventured to present a concise 
statement of such things as ought to be under- 
stood by those whose office it is to nurse the sick. 
And it is much to be desired that heads of families 
would give their serious attention to this subject, 
not only because they will be forewarned of 
danger, but be enabled also to judge when their 
nurses have properly discharged their duty, and 
what remedies ought to be applied when it has 
been neglected. 

Perhaps it is unnecessary to observe, that hon- 
esty and fidelity are essential qualities in a nurse. 
Perfect sobriety is likewise indispensable. The 
least approach to intemperance is a disgrace to 
every person, but unpardonable in those who are 
entrusted with the lives of others. Let nurses be 
aware of this shameful vice, never give way to 
the slightest excess, though at one time they may 
be exhilarated with joy, and at another depressed 
with care and fatigue; if they do, they will not 
only endanger the patient, but infallibly lose their 
own character, which once lost may never be 
regained, though their future maintenance may 
entirely depend on a good name. They should 



THE DUTIES OF NURSES. 27 

always be cheerful and respectful in their man- 
ners, and never incommode the patient with idle 
chit-chat, disagreeable subjects, or any thing that 
can occasion sudden surprise. They should never 
read the newspapers to the patient, lest they shock 
them by some paragraph or death in which they 
may be interested. These cautions will appear 
to be of the highest importance, when the feeble 
and excitable state of the mother is considered. 
An excessive and indiscreet loquacity, is suffi- 
cient to overbalance every good qualification in a 
nurse. They must learn to be very quick and 
expert in the execution of their office, yet without 
bustle or noise. 

In preparing all kinds of aliments, it is neces- 
sary to be very cleanly, but especially in those 
designed for the sick. Nurses, therefore, must 
not only be cleanly in their persons, and in the 
materials which they use, but they must take care 
that the vessels in which thev are dressed, are 
either silver or iron, or if copper, very well tin- 
ned, and kept as perfectly clean as possible. 
They should see that all the cloths which are 
used be perfectly dry and soft. 

If the nurse is present at the beginning of la- 
bor, it is her duty to arrange the bed, which she is 
often obliged to do as circumstances will permit. 
When a cot can conveniently be procured, it is 
sometimes preferred, as it can be gently drawn to 
the side of the bed, and the patient removed after 
delivery without undergoing any fatigue. This 
mot hod, therefore, may prove extremely useful 



28 THE DUTIES OF NURSES. 

in certain cases, but for general practice I recom- 
mend the following directions. The bed ought 
to be placed in such a situation that the room may 
be properly ventilated, without exposing the pa- 
tient to a current of air, and if practicable it 
ought to be kept at a little distance from the wall. 
The bed curtains, if the season makes it neces- 
sary to have them, should be made of thin mate- 
rials such as cotton or linen, and should never be 
drawn entirely round the bed; otherwise a free 
circulation of air will be prevented. A hair mat- 
tress should be placed on the feather-bed and over 
it a piece of oiled cloth, and above this a blanket 
ought to be spread. A sheet should then be laid 
on in the ordinary way, and another in the form 
of a roller across the bed, having the ends folded 
in at the sides. A coarse blanket folded within 
a sheet should be laid immediately beneath the 
patient, and should be removed after delivery. 
The upper sheet, blankets, and outer covering 
ought to be put on in the usual way, except that 
the edge of the cheet at that side of the bed to 
which the patient's back is to be placed, is to be 
pinned over the blankets and coverlet. The pil- 
lows should be so arranged that the practitioner 
can set behind the patient while she lies on her 
left side. 

By adopting these directions, exposure to cold 
during labor will be avoided; and the patient may 
be left comfortable after delivery, without being 
much disturbed, while all the necessary assist- 
ance can be given without inconvenience. 



THE DUTIES OF NURSES. 29 

The nurse should attend to the child, and be 
certain that it is safe and warm. In many cases 
it is a good practice to rub the body of the child 
over with olive oil or lard, and let it lay until the 
mother is made comfortable, when it may be 
wiped with a warm soft cloth and then washed in 
tepid water and a little castile soap; by this 
means the mucus with which it is generally cov- 
ered, may be entirely and easily removed, and 
therefore will render more than one washing for 
that purpose unnecessary. The child's mouth 
should at the same time be washed with a little 
spring water. 

The umbilical cord should be wrapped in a few 
folds of old linen, and the flannel bandage ap- 
plied over it, when the child may be dressed in 
the clothes which have been provided. If the 
child immediately shows a great desire for food, 
it may have a few tea-spoons' full of tepid water, 
in which a little brown sugar has been dissolved. 

In common cases, after the mother has rested 
and taken a little light nourishment, and her nip- 
ples bathed with warm milk and water, the child 
may be applied, as it will take hold with much 
more ease before the breasts get distended with 
a full flow of milk; attention to this may prevent 
many disagreeable feelings. 

Some infants are liable, a few days after birth, 
to the formation of a milky-like fluid in the 
breasts, which is apt to produce painful swell- 
ing and inflammation. The uneasy sensations 
occasioned by these swellings seldom continue 



30 THE DUTIES OF NURSES. 

above a few days, being sometimes relieved by 
the spontaneous oozing of the fluid. These swell- 
ings seldom require any other treatment than 
dusting with fine wheaten flour, or bathing the 
parts with warm milk and water, or rubhing them 
very gently with warm olive oil, evening and 
morning. Emollient poultices are never neces- 
sary, unless the swelling and inflammation are 
considerable. 

It should be universally known that the very 
common practice of ignorant persons forcibly 
squeezing the delicate breasts of a new-born in- 
fant, in order to discharge the milk, as it is called, 
is the most general cause of inflammation in these 
parts. The consequence of this practice is often 
suppuration and abscess; and hence besides the 
hazard of disagreeable marks in the bosoms of 
girls, the future woman may be prevented from 
ever fulfilling the duties of nursing. Parents 
cannot therefore be too careful in watching 
against this improper custom. 

Xurses should be cautioned never to expose 
the eyes of the child to bright fires or lights, and 
when there is the least appearance of soreness 
they should be frequently washed during the day 
in tepid milk and water. The most fatal conse- 
quences have ensued from neglect in this partic- 
ular. 



ON NURSING. 31 

CHAPTER III. 

ON NURSING. 

Though it is not now the custom, as formerly, 
for every opulent mother to throw her infant on 
the bosom of a stranger, for that nourishment 
which nature commands her to administer from 
her own; yet, it is still far too common for women 
of a certain class, and their imitators, to submit 
to this barbarous refinement, which is often inju- 
rious to the health of both mothers and children; 
and which all, who see it in a just point of view, 
should use their utmost endeavors to abolish. 

It is certain that there are women who, from a 
principle of conscience, should refrain from suck- 
ling; but the number of these unfortunate persons 
is comparatively so small, that if no others abstain- 
ed from the performance of this first maternal 
duty, the exceptions would be scarcely observa- 
ble. Women of a very scrophulous constitution, 
those who have strong symptoms of pulmonary 
consumption, and such as are liable to some sorts 
of uterine debility, should endeavor to remedy 
their own defects by procuring for their infants 
the milk of more healthy nurses. Some few, 
also, there may be, who, either by excessive de- 
bility of nerves, or uncommon weakness of stom- 
ach, are rendered unfit for this office; but, gen- 
erally speaking, every woman who is capable of 



32 ON NURSING. 

bringing forth a robust, healthy child, is capable 
of supplying its appropriate nourishment. 

Many women are discouraged from suckling 
their children, by apprehensions of the great con- 
finement and excessive fatigue attendant on the 
duties of a nurse ; and many others are induced 
to give it up, after the trial of a few days or weeks, 
on account of some temporary inconvenience or 
accidental malady. But none of these should 
prove sufficient obstacles to mothers really de- 
termined to follow the dictates of nature in this 
matter. No doubt the employment of nursing 
must be accompanied with a good deal of restraint 
during the first few months, but the inconveniences 
are not such as should ever deter a rich woman 
from making the attempt; and as to the poor, we 
know they are obliged to submit to necessity. 
None are so capable of executing this office with 
satisfaction, as those who have it in their power 
to hire the assistance of trusty and estimable per- 
sons to relieve them from a great part of the fa- 
tigue attendant on nursing; and, in truth, the 
services of such persons can never be too highly 
valued, nor too well rewarded. 

The greatest fatigue to which poor women are 
exposed in the time of suckling, is that occasioned 
by having their infants to sleep with them, espe- 
cially during the period of dentition, or any other 
troublesome indisposition; but to a woman who 
can repose in tranquillity, with no other disturb- 
ance than having the child brought to her two or 
three times in the night, and who is not obliged 



ON NURSING. 33 

to clean or to watch it during the hours usually 
devoted to rest, the fatigue is comparatively tri- 
fling; especially as the infant, (if well taken care 
of, and not of a sickly constitution,) will often 
sleep six or seven hours together. 

It is not indeed possible for a woman who is 
nursing to be long absent from her child during 
the first three or four months, but after that time, 
it may be brought to take regular meals, (eight, 
nine, or ten times a day, at stated hours,) so that 
the mother need not be prevented from going out 
for exercise or amusement during the intervals. 
At three or four months old, it might be advan- 
tageous to feed the child once a day,* the most 
suitable hour for which would be about noon; and 
when once it has become a habit, the mother may 
leave the child for three hours together, as it will 
probably sleep for two hours after this meal. 
This will be quite sufficient until the preparation 
for weaning commences, as the child at six or 
seven months old, will be able to eat a piece of 
bread out of his hand. I do not believe that a 
child who has plenty of milk would require any 
other food until old enough to show a desire for 



* The properest food for a child in health at this age, is 
very thin panada, made of good white bread and water 
which lias been already boiled and left to grow cold, with 
loaf sugar, sufficient to make it as sweet as the mother's 
milk. This should be given very slowly, from a little boat 
made of box-wood, and should not be hotter or colder than 
the natural food. Arrow-root or barley-water mixed with 
milk, may agree better with some children, 
o 



34 OX NURSING. 

it; but it is always prudent to prepare it, by the 
habit of feeding, to take medicine easily in case of 
illness, or to be weaned prematurely, if preg- 
nancy or any other accident, should render the 
mother incapable of continuing to afford it nour- 
ishment from her bosom. 

And here I must suggest that the danger of 
becoming pregnant is not nearly so great as is 
generally supposed. Very few women are liable 
to this accident during the first twelve months of 
giving milk ; and there are some who might con- 
tinue for three years without apprehension. A 
year is quite long enough for healthy children to 
suck; and, at any time after five months, they 
may be weaned with perfect safety, if no malady 
should intervene.* It is only necessary in case 
of being taken from the breast early, that par- 
ticular attention be paid to the quality and quantity 
of their food ; but this subject will be treated more 
at large in its proper place. 

A woman who is giving milk, should eatoftener 
than at other times; and, in fact, one who is a 

* Medical writers are undecided on this subject: the ma- 
jority however seem to be in favor of nine or ten months 
being a proper time for nursing ; still circumstances must 
determine, such as the robust or delicate state of the infant's 
health, and the season of the year; April and June are 
good months for weaning, as it regards the mildness of 
the climate and length of the nights. 

A London physician has lately published a work in 
which he gives it as his opinion that hydrocephalus and 
other diseases of that nature, are frequently caused by al- 
lowing infants to nurse for too long a time. Am. Ed. 



ON NURSING. 35 

good nurse, will have a much greater appetite 
during the period of suckling than at any other. 
She should not, however, be too ready to increase 
her quantity of meat, but rather let her additional 
meal or meals be of broth and bread, oatmeal, 
rice, or barley-gruel; or milk, if it agrees with 
her. A strict diet, and the prohibition of various 
sorts of food, is quite unnecessary; in all proba- 
bility, whatever has before agreed with the mo- 
ther will not injure the child, though perhaps, in 
regard to a hired nurse, a little more caution 
might be necessary. There is nothing more 
erroneous than the very common practice of giv- 
ing strong liquors, such as porter, ale, wine- 
whey, &c. to nurses: a woman who has been 
accustomed to these things may, certainly, con- 
tinue the use of them, but she should carefully 
avoid increasing the quantity. If giving milk 
should occasion great thirst, (as is sometimes the 
case) it should be assuaged with plain water, or 
milk and water, rice or barley-water, tea, or in- 
fusions of other herbs, &.c. ; but by no means 
with any thing of a spirituous nature. The ad- 
vice here given, is calculated for all ranks of 
society. Let the woman who is nursing, eat and 
drink whatever she has been accustomed to find 
agree with her stomach; but, let any additional 
food she may require, be rather of a cooling than 
a heating nature, both for hor own sake and that 
of her child. The powers of digestion in differ- 
ent persons being almost as various as their faces, 
it is impossible to prescribe exactly what sort of 



36 ON NURSING. 

food nurses should make use of. A certain kind 
of nourishment heing suitable to my stomach, is 
no reason that it should agree with another: there 
is, indeed, but one universal rule on this subject, 
and this should be extended to all persons, times, 
and situations, — Moderation in every thing. 

It is in the constitution of many women to be 
able to nurse only a few months, before the peri- 
odical evacuation returns to its usual course; but 
this should not be a subject of alarm; and some 
of the best nurses I have seen, have been of this 
constitution. It is, in fact, neither advantageous 
to the child, according to the prejudices of some ; 
nor injurious, according to the prejudices of oth- 
ers; but to the nurse it is rather debilitating, 
and therefore it is requisite for her to have more 
repose than usual during those few days. ;md 
perhaps take food of a more nutritious qual- 
ity. Should any retention afterwards occur, it 
will be right to watch whether the milk diminish- 
es, and how it agrees with the child's stomach, 
for fear of pregnancy, as in that case it would be 
better to begin weaning immediately; though I 
do not believe that the milk becomes directly so 
very unwholesome as is generally supposed: bui 
no woman can be strong enough to afford nour- 
ishment to both the child in her womb and that at 
her breast, without injuring herself. I must here 
again repeat, that women in general (whether 
they have menstruated or not) are by no means 
likely to become pregnant during the first twelve 
months of nursing. I lay a particular stress on 



ON NURSING. 37 

this point, because I well know that hired nurses, 
and those interested to protect them, insinuate 
every objection that can prevent women in other 
classes of society from bestowing the natural 
nourishment on their children; and that there are 
many ladies who are deterred from fulfilling the 
first duty of a mother, not by the fear of being 
obliged to stay away from this ball or that mas- 
querade, but by the dread of not doing justice to 
their offspring if they do not live exactly as the 
nurses whom they hire. Except in extraordinary 
cases, twelve month's milk is abundance for any 
child; and, to many, five or six would be sufficient; 
especially from the mother's bosom. Of course 
this must be understood of mothers who are free 
from the defects before specified. 

It is not by any means necessary that a woman 
who is nursing should lead the life of a recluse; 
and were it not for the present absurdly late 
hours, there would be no reason (after the first 
five or six months) why a lady, who suckles a 
healthy child, should not enjoy an hour or two of 
the diversions she has been accustomed to, even 
in the crowded assemblies of the metropolis. 
Whatever amuses the mind and raises the spirits, 
is beneficial during the period of giving milk; but 
all excesses are injurious at this time: and, in fact 
at what time are they not so? 

A woman who is suckling need not be alarmed 
by a fit of illness, unless it be of a very serious na- 
ture ; and to such maladies nurses are not very sub- 
ject. Those who have an interest in preventing 



38 ON NURSING. 

women of a certain class from nursing their child- 
ren, fail not to take advantage of the first indis- 
position, however slight, to suggest the necessity 
of either weaning entirely, or procuring a hired 
nurse to supply the mother's place: however, a 
mother, who is anxious to perform this her first 
duty, should not be influenced by their counsels, 
but immediately apply to some respectable phy- 
sician, who will either tranquillize her mind in 
pursuing her design, or give her satisfactory 
reasons for relinquishing it. A woman may be 
very ill without any bad quality being communi- 
cated to her milk; and a good medical practitioner 
is the only person who can decide whether the 
nature of the malady is such as to produce any 
injurious alteration. Those who are not rich 
enough to have the advice of a really skilful phy- 
sician, should observe with attention the state of 
the child: as long as it looks well and does not 
appear to surfer from indigestion, there is nothing 
to dread; but in cases of fever, as the milk is 
usually diminished by that circumstance, the 
mother should drink plentifully of diluting liquors, 
and (if necessary) the child should also be fed. 

A woman should never suckle her child im- 
mediately after any violent agitation of mind. 
Children whose nurses are of an irritable temper, 
are very liable to derangements of the stomach 
and bowels; and these effects, when produced by 
the milk of a stranger, have sometimes proved 
extremely dangerous. A nurse should keep her 
mind as tranquil as possible ; and, when disturbed 



ON NURSING. 39 

by any accidental circumstance, should delay 
suckling her child as long as she can without in- 
convenience, and until after she has taken food, 
I have known a child in perfect health attacked 
suddenly by convulsions, in consequence of the 
mother having imprudently put it to her breast, 
just after seeing a person fall down dead. 

Many advantages attend on the habit of mak- 
ing children suck at stated times; and this (when 
there are no particular reasons to prevent it) may 
generally be brought about before the child be 
three months old. It occasions a regular flow of 
milk to the breasts, which conduces much to the 
cleanliness and comfort of the mother; it renders 
the process of digestion easier to the stomach of 
the child; and it also removes some of the diffi- 
culties attendant on weaning. 

The chief point to be observed in a woman 
who is nursing, is whether the stomach be in a 
proper state. One who is subject to indigestion 
or other signs of debility in that part, cannot 
prove a good nurse while they continue : but this is 
no reason for not making an attempt. Every 
mother, who has none of these positive disquali- 
fications before-mentioned, should endeavor to 
suckle her child; and, in many instances, the 
employment would prove advantageous to her 
own health: if, however, after a fair trial, the 
weakness of stomach appears to increase, or even 
remain undiminished, it is a proof of some great 
defect (natural or acquired) in the woman's con- 
stitution, and, in all probability, the health of 



40 ON NURSING. 

both mother and child would suffer by persisting 
in the attempt to nurse. Delicacy of nerves, 
weakness of bowels, bilious complaints, and many 
other diseases, are not to be considered as imped- 
iments of sufficient importance to prevent awoman 
from suckling her own child, though they might 
justly be considered as such in a hired nurse; and 
(as I have said before) a slight illness is no rea- 
son for weaning a child. 

Among the lesser objections made to nursing, is 
the inconvenience of being constantly wet with 
the milk, the consequent sour smell, &.C. &c. 
All this is generally much exaggerated, and by a 
little attention may be avoided. A pocket-hand- 
kerchief, folded in such a manner as to be several 
times doubled over the breasts, is easily changed 
when it becomes wet, and all possibility of the 
milk passing through the outward clothes may be 
prevented by a piece of oiled silk* three or four 
inches square, (with the corners rounded off) cov- 
ered on both sides with linen, and sewed to the 
inside of the shift; by which means, even if the 
handkerchief should be wet through, the milk can-- 
not penetrate the oiled silk; and, by changing the 
handkerchief as often as is requisite, all the above- 
mentioned inconveniences are avoided. There is 
no occasion for the oiled silk in the night-shift, as 
a couple of pocket handkerchiefs, not folded, but 
gathered up, (as is done to put in the pocket,) 



* This should be exposed to the air for some time before 
it is used, to take off the disagreeable smell. 



ON NURSING. 41 

will be sufficient to prevent the passage of the wet, 
if the mother takes care to suckle her child the last 
thing before she goes to rest. 

I am thus particular about trifles, because I wish 
to remove every objection, which may occur to 
the most scrupulous person, in a matter of so 
much importance as the first duty of a mother. 
As soon as the child can be brought to take regular 
meals, the milk will flow into the breasts at regular 
hours, (which by-the-by tends much to preserve 
the form of the bosom,) and ail the inconven- 
iences of suckling will be greatly diminished. A 
woman who cannot submit to a little trouble, 
which lasts but a short time, for the benefit of her 
child, does not deserve to have a child. 

It is of great importance for a nurse to avoid 
all unnecessary fatigue, and there are few things 
which tire more than bending forward to suckle an 
infant on the lap : for this reason, until the child 
is old enough to sit while it is sucking, or the 
mother expert enough to raise it in her arms to 
the breast, it would be better for her to lie down 
when the child has occasion to suck; at least 
during the first five or six weeks, when women 
are so subject to weakness and pain in the back. 

Many a mother has been deterred from contin- 
uing to suckle her child, by an inconvenience of 
the most painful sort, to which some persons are 
extremely liable, and from which others are com- 
pletely exempt. I mean what are called chopped 
or sore nipples, — a complaint which many women 



42 ON NURSING. 

require the greatest care to prevent.* The 
best means of avoiding this, is to prepare for 
nursing during the last five or six weeks of 
pregnancy, by putting a little brandy on the nip- 
ples twice a day; taking care previously to apply 
a little butter, and with a soft rag to rub off any 
part of the skin which can be removed in this 
way: once will be sufficient for this, and the brandy 
will harden the soil skin afterwards. Just before 
the child is put to the breast, the brandy should 
be applied, and also, as soon as the nipple is out 
of its mouth. There is no occasion to be very 
particular in v iping off* the brandy, but merely 
to touch the part gently (with a bit of fine linen) 
before the chili sucks; the infant cannot be in- 
jured by what may adhere of the brandy, and the 
mother may, bj rubbing the skin too hard. The 
nipple should be kept constantly covered with 
something soft and cool, until all danger of sore- 
ness is past, which will be in about five or six 
weeks. The best substance that can be used for 
this purpose is the skin of a calf's kidney, cut 
into pieces about an inch and a half square; these 
should be keot in rose-water, and changed every 
time the child is put to the breast, drying them 
well first, and warming them between the hands, 
or with the breath, lest they should occasion any 
sensation of cold, which it is of the greatest im- 
portance to avoid. For the same reason, on tak- 



*The pickle of salted meat boiled, is thought very good 
for this purpose. Am. Ed. 



ON NURSING. 43 

ing the child from the breast, the mother should 
instantly cover the nipple with her hand, and be 
careful to draw her clothing over that side before 
she strips the other, for the impression of the air, 
after the heat of the child's mouth, may cause a 
chill. These are, in appearance, very trifling sub- 
jects to dwell upon, but they are of great impor- 
tance to a woman who suckles, and such as none 
can explain but those who have learnt by experi- 
ence. 

Though a woman is afflicted with sore nipples, 
she should not for that reason be persuaded to 
give up nursing. She must only contrive to put 
the child as seldom as possible to the breasts, that 
they may have time to recover, and therefore she 
should give only one side at each meal; this is, in 
fact, quite sufficient during the first few weeks; 
only when there is no reason to the contrary, it 
is more convenient to make the child take half 
its quantity at each side, that the milk may be 
equally divided. Many ointments and washes 
are recommended for the cure of sore nipples, 
but I know of none so safe as honey of roses, 
which there is no occasion to wash off before the 
child is put to the breast.* 

* An experienced mother has found that to nurse her in- 
fant as little as possible during this extreme tender state of 
the nipple was a better remedy than any thing which could 
be applied, but this method, if adopted, requires great at- 
tention. The milk must be kept well drawn off either by 
steam,* the glass-pipe, or by wearing glass shells. The milk 

♦To draw off the milk by steam, a ground glass decanter should be 



44 ON NURSING. 

The persons about women of fortune, are always 
ready to catch at the first shadow of an obstacle, 
to persuade them to relinquish the task of nurs- 
ing, and the accident of the nipples becoming 
sore, has been the occasion of many disappoint- 
ments. I once knew a lady who was on the point 

should be saved and the infant fed slowly with it. If the 
infant be put to the breast as often as it cries, the nipple 
will be longer in healing and the mother's sufferings thereby 
prolonged. 

The silver shell or any other which applies quite close, so 
as neither to absorb nor allow the vapor which arises from 
the evaporation to pass off, prevents the nipple from healing 
as long as it is kept in this soft state. The glass shell is 
generally preferred on account of the aperture at the top 
and the power it has of drawing off the milk. Before the 
shells are put on, it often lias a good effect to bathe the 
nipple with pretty strong brandy and rose-water, and oc- 
casionally to dust on a little calamine or peruvian bark. 
They must neither be kept too dry nor too moist. A watch- 
ful and attentive nurse will understand when to apply cold 
cream with the astringent powders, instead of brandy. 
This affliction is a great drawback on the strength of are- 
covering mother, and one of the strongest aids is her own 
resolution to bear with firmness the pain inflicted by putting 
the child to the breast; it does not often continue many 
weeks and when she has persevered until a recovery, she 
is more than compensated for all she has endured. 

An artificial nipple covered with a prepared cow's teat, 
was some time ago invented as a protection to the sore nip- 
ple ; and when the infant can suck through it (which is not 
always the case) it proves exceedingly useful and saves the 
mother a great deal of pain. These artificial nipples can be 
procured of the apothecaries. Am. Ed. 

filled with nearly boiling water and let stand a few minutes, when th« 
water should be poured out and the mouth of the decanter immediately 
applied to the nipple. 



ON NURSING. 45 

of yielding to the advice of an old nurse, who as- 
sured her it was impossible for her to continue to 
suckle on this account, when she happened to 
overhear one of the housemaids (who was making 
her bed) say to the other, " God help the pobr! 
If my lady Avas a poor woman, she would be 
obliged to go on suckling the child." The lady, 
being one of those persons who consider nursing 
as a positive duty, was shocked to think that any 
thing short of absolute impossibility should pre- 
vent her from performing it, and determining to 
support as much pain as a poor woman could 
have done, succeeded perfectly in her attempt. 
During the whole time of giving milk, it is par- 
ticularly necessary to avoid wearing any thing 
tight across the bosom, and also to shun the im- 
pression of very cold air; the last should be guard- 
ed against by a light covering, for any thing too 
warm over a part which must necessarily be so 
often stripped, might occasion exactly the bad 
consequences it is designed to prevent. Many 
women require some support under the breasts 
during the time of suckling, but this should be 
made with great caution; stiff stays, or any other 
article of clothing that can press on them, as well 
as damp or cold, may at any time during the pe- 
riod of nursing, occasion an obstruction in some 
of the milk vessels, and produce a painful and te- 
dious malady, ending in an abscess. This more 
frequently occurs during the first few weeks, be- 
cause the bosom is at that time more susceptible 
of all impressions; but a woman who is giving 



46 ON NURSING. 

milk is never perfectly secure from it. The first 
symptom of the obstruction, is a sensation of tight- 
ness, accompanied with pain, resembling a slight 
rheumatism in some part of the breast, when a 
hard lump is felt, and the pain increased on touch- 
ing. In a few hours after (sometimes sooner, 
sometimes later,) a fever commences, with violent 
shiverings: the best thing that can be done then, 
is to go immediately into a bed well-heated, and to 
drink plentifully of such warm diluting liquors as 
are most likely to keep up a constant perspiration. 
At the same time local applications should not be 
neglected; but those must be managed with 
the greatest caution, to avoid any impression of 
cold while they are changing. A bag of hot bran, 
or a poultice of oatmeal laid upon the spot where 
the hardness is felt, so as to keep it in a continual 
sweat, will sometimes disperse it in four-and-twen- 
ty hours, especially if the child be strong and sucks 
often; and, to avoid all danger in uncovering the 
ailing breast, a piece of soft flannel (covered with 
linen) with a hole in it just large enough to let the 
child take the nipple conveniently, should be warm- 
ed and laid over it when the poultice is taken off; 
and care should be taken that this last be hot when 
it is put on again. 

I remember once to have seen a person cured 
by taking in bed during the shivering fit, a large 
glass of weak hot punch, which produced a violent 
sweat, that was kept up, by drinking elder-flower 
tea, more than four-and-twenty hours: at the same 



ON NURSING. 47 

time a poultice of hot polenta* was applied to the 
part affected, and changed every two hours. This 
woman had been giving milk about seven months, 
and was perfectly well on the morning of the day 
on which the malady commenced, but having oc- 
casion to walk to some distance, and the weather 
being very cold, she put on for warmth a dress 
which she afterwards found too tight on her bosom; 
and as she was returning home, suffered much at 
the same time, from a penetrating wind. The 
pain and swelling of the breast was felt at three 
o'clock in the day, but the fever did not com- 
mence till about nine at night. The complaint 
went off entirely in three days, and one thing 
which contributed much to the cure, was the child 
being very strong and sucking a great deal. 

It frequently happens that a malady of this na- 
ture, after being neglected for some hours, baffles 
all the power of resolvent applications, and turns 
to a painful tumor, which in the course of some 
weeks, ends in suppuration. For this reason, if 
the common remedies produce no effect after the 
trial of a few hours, and the inflammation runs 
high, a professional man should be consulted 
without delay, as local bleeding and other medi- 
cal assistance may still suffice to check the pro- 
gress of the complaint. 

All physicians agree that when a mother is 

* Polenta is thick porridge made of Indian corn and 
water, and is common food in the country where this cir- 
cumstance occurred. 



48 ON NURSING. 

able to suckle her children, there is nothing which 
contributes more to her own health as well as 
theirs; and it has been often remarked, that wo- 
men are less exposed to death during the time of 
pregnancy and of nursing, than at any other pe- 
riod of their lives. It has also been frequently 
observed, that the latter is particularly favorable 
to beauty, and this is by no means an illusion of 
the imagination ; for the prosperous state of health 
which it produces, and the satisfaction attendant 
on fulfilling a great, and at the same time an 
agreeable duty, must clear the complexion and 
brighten the countenance. But it is an extraor- 
dinary fact in the history of mankind, that a duty 
which requires no written law; a duty which is 
ever the same in all countries and in all ages; a 
duty respecting which there can be no difference 
of conscience, no speculative doubts; a duty, in 
Bhort, which is pointed out by the Creator of all 
beings; should have been so often and so gener- 
ally neglected; and that women, the most scrupu- 
lously exact in their attention to all lesser obliga- 
tions, should have considered themselves exoner- 
ated from the most important. But this is one 
of the many inconsistences which abound amongst 
human creatures in a state of civilization, and 
which almost justify a doubt of their being design- 
ed for such a state. 

It appears to me that enough has now been 
said on this subject, to encourage and assist those 
women who really wish to suckle their children; 
and it is also to be hoped that the contents of the 



ON NURSING 49 

foregoing pages may be sufficient to determine 
such as waver, or have obstacles thrown in the 
way of their intentions. To convert those who 
spontaneously oppose the laws of nature, is far 
beyond my expectations. 



In regard to Weaning, it is of equal importance 
to the mother and child, that it should be done 
by slow degrees; and if the child is a twelvemonth 
old and in good health, it need not be a matter of 
great difficulty. One meal only should be taken 
away at a time, and for this some other sort of 
food should be substituted. The mother must 
consult her own convenience respecting the hour 
suitable for this privation; but, if not hurried by 
any particular circumstance, she ought to make 
no farther change for a week after taking away 
the first meal of milk, and give about six weeks 
to the entire weaning; leaving an interval of four 
or five days after every diminution of the milk 
diet. Much inconvenience to the mother is avoid- 
ed by this mode of weaning ; and the child becom- 
ing by degrees accustomed both to the change of 
diet and the privation of the amusement of suck- 
ing, escapes what old nurses (and even some 
medical writers) consider as a disease, under the 
name of the weaning brash; an indisposition en- 
tirely occasioned by imprudence. 

When a woman has almost completed the wean 
ing of her child, she should diminish the quantity 
of her nourishment, and abstain from drinking, 



50 ON NURSING. 

more or less, according as she finds the state of 
her milk. If (when the child has quite left off* 
sucking) she finds the milk continue in such 
abundance as to give pain, she should take some 
purgative* medicine; but it is very probable that 
in gradually weaning, the milk without this assist- 
ance, may go away of itself, which is far prefer- 
able. To those women who are able to milk their 
breasts themselves, it is easy to obtain relief if 
oppressed by the quantity, and for those who can- 
not, there are artificial aids.| Should there be 
much uneasiness from swelling, a little oil of sweet 
almonds, rubbed on gently, two or three times a- 
day, is the best application to make use of; and 
the breasts, as long as there is milk in them, 
should be covered with flannel, or soft fine wool. 
That part of weaning which belongs to the 
management of infants, will be treated of in its 
proper place. 

* One of the best for this purpose is the sulphate of po- 
tass (sal polychrest), of which may be taken from two 
drams to half an ounce. 

i Great care should be taken when recourse is had to 
artificial means. Am. Ed. 



PART THE FIRST. 



TREATMENT OF INFANTS FROM THEIR BIRTH TILL 

i 

AFTER TWO MONTHS OLD, AND THE MALADIES 
TO WHICH THEY ARE LIABLE DURING THAT 
PERIOD. 



CHAPTER I. 

MANNER IN WHICH A NEW-BORN INFANT SHOULD BE 
WASHED AND DRESSED WOODEN BATHING-VES- 
SEL CUSHION STUFFED WITH CHOPPED STRW 

NO PINS IN THE CLOTHES FIRST SHIFTS. 

The physical and moral education of man 
should both commence from the first moment of 
existence; and, in fact, they are so closely united, 
that it is impossible to neglect the one without 
committing error in the other. 

The infant just expelled from the womb of its 
mother, is a being of such a delicate nature, that 
it requires to be handled with the utmost caution; 
for it is very possible that a slight injudicious 
pressure on some important part at this time, may 



52 TREATMENT OF INFANTS 

occasion deformities in mind and body, which do 
not attain their full developement till many years 
after, and are then ascribed to causes far different 
from the true. For this reason it were much to 
be wished that the women whose office it is to 
perform the earliest services to new-born infants, 
might always be well-instructed nurses; and that 
no one, who has not some knowledge of the organ- 
ization of the tender being, should be allowed to 
wash or to dress it in its first state of natural de- 
bility. • 

Any one who has observed the different manner 
in which an ignorant and a skilful nurse touch an 
infant just come into the world, must have been 
struck with the extraordinary contrast. The 
former, supposing it a thing of course that the 
child should squall, tosses and rolls it about with- 
out ceremony, as it" it were only a bundle of raga; 
whilst the latter lifts it in the gentlest manner, 
avoids every sudden motion, and endeavors by all 
means to save it from uneasiness. I have myself 
seen a skilful nurse" wash and dress a robust in- 
fant for the first time, without once making it cry. 
The thing is therefore possible; but not indeed 
if it is to be immediately washed in cold water, 

* In some cases the shape of the head is much altered, in 
consequence of long continued pressure during the birth of 
the infant; but it very soon recovers the natural form. The 
practice among nurses, therefore, of endeavoring to give 
the head a proper shape by squeezing and pressing it with 
the hands is unnecessary, and ought never to be allowed, as 
it is a very dangerous practice. Am. Ed. 



TILL AFTER TWO MONTHS OLD. 53 

as is practised in some places. This custom has 
been opposed by many eminent physicians, and 
I am convinced it can never be too much discour- 
aged. The use of cold water, during the first 
weeks of existence, is very likely to occasion those 
pains in the bowels which are so common among 
young children, that old nurses consider them as 
necessarily belonging to their age; but which are 
probably amongst those maladies which might be 
prevented by judicious treatment. A slight aug- 
mentation of cold in the atmosphere is capable of 
producing spasms and diarrhoea in adults of deli- 
cate constitutions, and there is every reason to 
suppose that infants are affected in the same man- 
ner: how much more, therefore, by the immedi- 
ate contact of cold water ! 

It is painful to witness the severe discipline 
that children are usually submitted to so soon as 
they come into the world, preparatory to being 
exhibited for the admiration of relations and other 
visiters. In the first moments of their existence, 
they suffer through the vanity of those around 
them; and not unfrequently in so great a degree 
as to save them from every suffering by their own: 
for children, when they happen to be born ex- 
tremely delicate, are not always able to survive 
the fatigue of being washed and dressed by an 
unskilful hand. 

The first wrapper of a new-born infant should 
be a piece of light flannel, lined with soft linen, 
in which it should be covered all over, except on 
the face; and if the person who receives it be 



54 TREATMENT OF INFANTS 

not expert at passing this over the head conven- 
iently, a little cap of the same materials should 
be prepared, so that no part, but what is neces- 
sary for breathing, should be exposed to the air. 
In this state it should be allowed to remain, lying 
perfectly still (on its side) for a convenient time; 
but not left unobserved, as some accident might 
occur for which medical assistance would be re- 
quisite.* 

The Avashing of a new-born infant ought not 
to give it pain; and in fact, if performed in a 
suitable manner, would rather be likely to occa- 
sion agreeable than disagreeable sensations. The 
best method I have ever seen, is that employed at 
Vienna, where they have for this purpose awooden 
vessel made in the form of a long oval tub, of di- 
mensions proportioned to the use for which it is 
designed. It is filled with tepidf water (in which 
may be mixed a little brandy, or soap if thought 
necessary,) and in this bath the infant is placed 
by the attendant, who supports it under the bark 
of the head with one hand. After it has remain- 
ed three or four minutes in the water, which 
should be in sufficient quantity to make it float, 
she rubs it tenderly all over with a soft sponge, and 
then dries it gently with a warm napkin. An at- 
tendant should be ready to cover the child the 
moment it is lifted out of the water, and care 
should be taken to put the napkin first over (rather 

* Nurses should particularly attend to this. Am. En. 
i As warm as milk just drawn from the cow. 






TILL AFTER TWO MONTHS OLD. 55 

than under) its body, as this will prevent it from 
feeling a painful sensation by the impression 
of the comparatively cold air. It is carcely ne- 
cessary to add that this first washing should take 
place in a warm room, with all doors and windows 
closed. 

Besides the wooden vessel above-mentioned, 
there is also prepared a large square cushion, 
which is used in dressing the child; and this is 
laid on a table, which is extremely convenient for 
the person employed in this office. It is filled 
with chopped straw in such a manner as to be 
pliable to the weight of the infant, and may be 
pressed into any form that is commodious. On 
this, the child is laid when taken out of the bath, 
a warm napkin having been previously spread 
over it; and after being well dried in a position 
which gives no fatigue, the child is thus dressed 
without having its arms pulled about unnecessarily, 
or being forced into the unnatural posture of sit- 
ting. The clothes of the child are made to fasten 
behind, and so shaped as to cover the breast and 
arms; a necessary precaution in cold climates, 
and an advantage in all. Indeed I have been 
convinced by repeated observation in various 
countries, that children who have their bosoms 
and arms covered for the first two years, are not 
subject to those severe coughs and inflammations 
of the lungs, which are during the time of teething, 
fatal to so many in this country. 

Another thing in the dress of infants at Vienna 
(as well as in many other places on the Conti- 



56 TREATMENT OF INFANTS 

nent) deserves also to be imitated; which is, that 
not one pin is employed in their clothing, every 
article that requires to be fastened, having strings; 
and the person who ties them, turns the child on 
its side as it lies on the straw cushion, so that it 
suffers no inconvenience. Some nurses may, 
perhaps, say that it is impossible to dress a child 
entirely without pins: but what is done in one 
place may be done in another, and I recommend 
nothing of which I have not witnessed the ad- 
vantage. 

So long as it is necessary to have the child 
swathed, this is done with peculiar ease by laying 
it on its back on the straw cushion, holding up 
the feet with one hand, and rolling the bandage 
round it with the other. The only pressure that 
should be made on the body of an infant, is 
that which is required for some time after the di- 
vision of the umbilical cord; and which is often 
a beneficial part of the clothing, after it has ceas- 
ed to be the necessary bandage of a wound. The 
swath should be made of soft linen or cotton 
doubled, without seam or hem, and should have 
two strings at one end, long enough to go once 
round the body and to tie. It should be rather 
more than an inch and a half in breadth and two 
or three yards in length, according to the size of 
the child.* When this is applied by a judicious 

* It may be useful to say here a kw words on the manage- 
ment of the navel. The portion of cord which is left next 
the belly, usually drops off within five or six days after 
birth and leaves a tenderness, the removal of which is 



TILL AFTER TWO MONTHS OLD. 57 

hand, it is in many cases advantageous, espe- 
cially when there has been any griping or loose- 
ness, both on account of the warmth, and of the 
gentle pressure on the bowels; and might in some 
instances be continued with good effect for three 
months, or even longer, if the weather be cold: 
for no diminution in a child's clothing should ever 
take place except in a warm season. 

The first shifts should be made with broad, flat 
seams, and should never be large enough to fall 
into plaits; every thing that touches the skin of 
an infant should be soft and smooth; those there- 
fore who cannot afford to have shifts of fine cam- 
bric, should make use of very old linen or cotton 
for this purpose. Every thing the child wears, 
should be made to tie with narrow tape or flat 

greatly accelerated by applying a split raisin underneath 
the singed rag which is commonly used. 

But sometimes whatever precautions are taken, a soreness 
round the edges, or some degree of ulceration remains and 
proves very difficult of cure. This arises, in some cases 
from a small excrescence, not so large as the half of a gar- 
den pea, sprouting up from the root of the cord, and in 
other cases from an erysipelatous inflammation. As the 
most fatal consequences have been occasioned by neglect in 
such cases, and as a variety of treatment is necessary under 
different circumstances, a practitioner should always be 
consulted. 

The cord should be always left until it drops off of itself, 
lus pulling it away forcibly (as is too often done by the in- 
experienced) proves exceedingly injurious to the infant. 

The bands used in this country, which are four or five 
inches in width and a little more than half a yard in length, 
are thought sulliciently large. Am. Ed. 



58 TREATMENT OF INFANTS 

bobbin, and care should be taken to put the knots 
where they cannot occasion uneasiness. 

To many readers this exactness may appear 
superfluous: for those who have not been accus- 
tomed to observe young children with a medical 
and philosophic eye, are by no means aware of 
the early developement of their physical and moral 
sensibility, and therefore do not pay sufficient at- 
tention to the trifling circumstances which may 
hurt their feelings. An affectionate motber will 
not, however, despise these precautions, but con- 
sider every hint which may contribute to the wel- 
fare and comfort of her infant as well deserving 
her notice. 



CHAP. II. 



CLEANLINESS EXCORIATIONS WASHING THE 

MOUTH FLANNEL NIGHT DRESS CAPS 

TIME OF WASHING OF DRESSING. 

Tbere is nothing of greater importance to the 
health of young children than cleanliness, though 
in some cases this (as I shall show hereafter) 
may be carried too far. If the first bath does not 
perfectly cleanse the skin of the new-born babe, 
it should be repeated in the same manner the next 
day ; and after this second washing, it seldom hap- 
pens that a third bath is necessary for the mere 
purpose of cleaning, though it may be required 



TILL AFTER TWO MONTHS OLD. 59 

medicinally in case of gripes, eruptions, Sec. &c. 
Afterwards it will be quite sufficient to wash the 
head and face, the throat, the hands, the arm-pits, 
and those parts which come in contact with the 
excrements ; and this should be all done with tepid 
water and a fine sponge: a soft warm towel should 
be used for drying. The head may be washed 
once a-day with tepid water and a little brandy; 
once a-day is also sufficient for all the other parts, 
except those liable to be touched by the evacua- 
tions. When the towels are wet with urine, the 
child's skin should be wiped dry before fresh linen 
is applied, and when there has been a discharge 
from the bowels, it should be washed clean with 
the sponge and tepid water. 

If great care be not taken in washing the 
creases made by the flesh of very fat children, 
they are liable to have the skin of those parts 
become sore and inflamed: bathing them, fre- 
quently, with spring water or rose-water, is gen- 
erally sufficient to prevent this inconvenience; 
but sometimes it is necessary to apply some sort 
of powder. For this purpose various substances 
are employed: in some places common .hair- 
powder is used: in others the powder of decayed 
wood, and sometimes hair-powder mixed with a 
little sulphur: but I believe all that is necessary 
(in general,) after washing and drying well, is to 
apply some farinaceous substance to the parts in- 
clined to be sore. Great care should be taken 
that nothing irritating is used, and therefore the 
common hair-powder sold in the shops is not 



60 TREATMENT OF INFANTS 

perfectly safe. Starch well powdered and dressed 
through a fine seive is, probably, the best thing 
that can be employed for this purpose.* Fine 
rags dipped in rose-water and laid on the parts 
are sometimes beneficial, and to render them 
more so, they may first be smeared with a little 
clean suet or spermaceti ointment. If these ap- 
plications are not found sufficient, the advice of a 
physician should be asked before any astringent 
substance is tried; as these excoriations may be 
produced by causes which require medical aid to 
discover, and to cure. 

When there is no disease in the mouth of an 
infant, it should never be cleaned with any thing 
lint a soft linen rag dipped in fresh spring water. 
This should be repeated three or lour times a day 
(luring the lirst month (afterwards once a day will 
lie sufficient), and when done with gentleness, 
usually gives pleasure to the child. I have often 
been distressed by the shrieking of infants a few 
days old, during the operation of having their 
mouths cleansed with sugar and other substances, 
which old nurses think proper to use for this pur- 
pose; and I am inclined to suspect that the man- 
ner in which these are applied is one cause of the 
sore mouth so frequently to be met with (in the 
first month) as a mere local complaint. When I 
have seen nothing employed but cold water, I 
have seldom observed a child to cry, or ever be 
affected with this species of indisposition. 

* Prepared calamine is sometimes preferred. Am. Ed. 



TILL AFTER TWO MONTHS OLD. 61 

The clothing of young children should be light, 
warm, and loose; indeed it should be such at all 
ages; but we ought to be more particular in pay- 
ing attention to the comfort of infants, in their 
first state of weakness, when we cannot judge how 
much they may surfer from oppression, cold, and 
pain, than at a more advanced age, when they 
become capable of expressing their sensations by 
words. Fine flannel is certainly the most appro- 
priate substance that can be employed in the cov- 
ering of children, and care should be taken that 
their clothes be moderately loose without being so 
large as to incommode. The use of woollen 
clothing is advantageous to children of all ages, 
and is frequently beneficial in a medical point of 
view, when applied next the skin; but by those 
who are in health, it should always be worn over 
linen, except on the feet of very young children 
which are, I believe, in the British Islands gen- 
erally covered with flannel, and to good purpose. 
The long petticoats (when not too heavy) are of 
great use ; they keep the lower extremities warm, 
save infants from the trouble of wearing shoes and 
stockings, and also prevent servants from teach- 
ing them to walk too soon. 

A child who sleeps with his mother or nurse 
will not require flannel about the feet at night, 
but it should always have a night-dress to put 
over the shift worn by day. A waistcoat made 
to cover the chest and arms, and fasten behind, 
is the best form of additional clothing; and in 
cold weather this should be made of very soft 
flannel. 



62 TREATMENT OF INFANTS 

Whatever covering is put on the head should 
be light; and, generally speaking, the thinner a 
child's cap is, the better: but this of course must 
be adapted to circumstances, and experience may 
show that one child requires to have the head 
kept warmer than another.* No positive rule 
should be laid down, as there must always be some 
exceptions. Great care should be taken that the 
caps be not too tight; the chin-stay should be 
broad and soft, and left rather loose. 

With respect to changing the linen on the body 
of a young infant, there are different opinions; 
but in this (as in almost every thing else) the 
middle path is the best, and consequently the 
shifts should not be left too long without chang- 
ing, nor be changed too frequently. Every se- 
cond day (or perhaps every third) would be often 
enough; however, the least appearance of dirt or 
bad smell (which may easily arise from a drop of 
milk running down on the bosom) should be a 
reason for putting on clean linen; which should 
always be well aired, and warm during the first 
few weeks, and perhaps longer. 

No alteration in an infant's clothing should be 
made when it is sleepy; and, for this reason, 
whatever is to be put on before it is laid to rest, 
should be such as requires but a moment's 
arrangement, that its temper may not be irritated 

* In this country it is becoming the custom to dispense 
with caps altogether, and I think with good reason. The 
head is frequently kept too warm, and disease thereby occa- 
sioned. Am. Ed. 



TILL AFTER TWO MONTHS OLD. 63 

by delays when it is impatient for repose; indeed 
a child should always be undressed before it is 
oppressed by sleep; and the regular time for 
changing its shift, washing, and every other 
necessary annoyance, should be soon after it 
awakes in the morning. 



CHAP. III. 



MODES OF CLEANLINESS OF SLEEPING CRADLE 

CARE OF SIGHT, AND OF ALL THE SENSES. 

The comfort of young children should be attend- 
ed to in every respect ; and there are few things 
which gives them more uneasiness than having 
their clothes wet with their urine. It is not suffi- 
cient to watch that this should never occur in the 
day-time, but it is also particular necessary to 
guard against it in the night. The best means 
of doing so, is to have a piece of oil-cloth about 
two feet square, covered with a flannel case, to lay 
under the child in bed. The oil-cloth should be 
exposed to the air for some time before it is 
applied to this use, that the bad smell may go 
off; and it should never be allowed to touch the 
child without the flannel case, as the cold (or 
perhaps some other qualities) of this substance 
might be hurtful. The flannel should always 
have a linen towel laid over it, but not a case of 



64 TREATMENT OF INFANTS 

linen, as this last could not be removed without 
much disturbance, whereas the towel may be 
easily changed; and, if the flannel should have 
got wet, the whole may be turned in a moment; 
however, if care be taken to arrange the towel 
conveniently, and to change it when necessary, 
the flannel will, probably, remain sufficiently dry; 
at the same time, it would always be expedient to 
have a second oil-cloth and flannel case prepared, 
lest the one should happen to be wet on both 
sides. This contrivance is also useful to the 
mother or nurse with whom the child sleeps, as 
by drawing the oil-cloth up between her and it, 
she may avoid the disagreeable sensation of be- 
ing wet by the urine of the infant. 

Children, in perfect health, may soon be taught 
cleanliness, by putting a vessel under them on the 
lap when there is any sign of their having an 
evacuation; and when once accustomed to this, 
they are not content to do without it. This prac- 
tice may be begun at live or six weeks old, if 
there be no reason against it; but, in case of a 
violent cough or lax, it must be discontinued, as 
a descent of the lower bowel is not an uncommon 
complaint in infants; and, therefore, when any 
malady occurs which may cause weakness in this 
part, it should not be left unsupported.' Child- 
ren, who have acquired habits of cleanliness, and 

* For the same reason the little chairs which are made 
for children of one or two years old, should always have 
the hole as small as possible. 



TILL AFTER TWO MONTHS OLD. 65 

who have careful observing attendants, may be 
left without towels (in a great measure) at four or 
five months old, and this is always an ad- 
vantage. 

It is a matter of dispute whether an infant should 
sleep at some distance from its nurse or on her 
arm, and several medical men have asserted that 
the latter is extremely unwholesome. No doubt 
the person who sleeps with a young child should 
never keep it so close to her mouth, as absolutely 
to inhale her breath; but otherwise, it is probably 
a matter of indifference, and it can scarcely be 
injurious to an infant, to come in contact with the 
body from which it derives its proper nourishment. 
I have seen many fine children who have slept on 
their nurses' arms till eight or nine months old; 
but when the nurse happens to be a heavy sleeper, 
this may be attended with danger; and in such a 
case, the various circumstances must be consider- 
ed, and the most expedient plan adopted. It is 
scarcely necessary to say, that no person who 
suckles a child, should allow it to lie at the breast 
for hours at night, while she sleeps; the infant 
could scarcely acquire a worse habit, and it is at- 
tended with numerous inconveniences. 

The use of the cradle has been objected to by 
many persons, and some have gone so far as to 
assert that it deranges the brain. There can be 
no doubt that violent motion of any sort is capa- 
ble of injuring the brain, as well as other impor- 
tant parts of a new-born infant; but when a gentle 
movement is beneficial and composing, (especially 
4 



66 TREATMENT OF INFANTS 

in illness) it has always appeared to me that the 
regular motion of being rocked in a cradle, is far 
preferable to being carried and jerked about in a 
woman's arms according to lfer caprice, especially 
in very cold or very hot weather; in the former, 
because of the probability of some part being ex- 
posed to the air which ought to be covered, and 
in the latter, because of the child being heated 
by the contact of animal warmth, when perhaps 
it ought to be kept particularly cool. The most 
reasonable objection which has been made to the 
use of a cradle is, that it gives children a bad 
habit, a want more than is necessary; but, as 
there are many cases in which the advantages 
greatly preponderate, it is at any rate, one of 
ibose matters in which opinions may differ without 
occasioning any bad effect. 

At the same time that I approve of the use of a 
cradle, I should by no means recommend putting 
an infant to sleep in it at night: on the contrary, 
I am convinced that the warmth of the nurse is 
extremely beneficial to the child; and we may 
observe amongst our domestic animals (from whom 
many a useful lesson might be taken by human 
mothers) that instinct always leads them to impart 
the heat of their own bodies to their offspring, in 
this first state of weakness. 

Attention to circumstances apparently trifling, 
may often prevent both maladies and deformities. 
It is generally known, though not always suffi- 
ciently observed, that the manner in which the 
bed or cradle of an infant is situated, may occasion 



TILL AFTER TWO MONTHS OLD. 67 

a permanent squint. Young children should never 
have the light on one side ; neither is it good to 
have it opposite the eyes. The best position is that 
in which the light may come from behind, but not 
in such a manner as to cause the infant to throw 
up its eyes: any thing that occasions a momentary 
distortion may be productive of bad consequences, 
and therefore in playing with young children, Ave 
should always take care to be nearly in front of 
them, lest they should be induced to give any 
forced movement to their eyes. There should be 
no glaring colors opposite to an infant's bed, and 
it should not be suffered to fix its eyes long on a 
lighted candle, or on anything that glitters. The 
irritation of strong lights and of brilliant colors, 
is very likely to produce those inflammations in the 
t:yes which are ascribed to other causes, and often 
pass for the effects of cold: and parents, who are 
very anxious about every thing which concerns 
the welfare of their children, should pay great 
attention to the color of the walls of those apart- 
ments particularly destined for their use. Green 
is generally considered to be the color most bene- 
ficial to the sight, but there are many shades of 
gray and brown sufficiently inoffensive to be placed 
before the eyes of infants. Servants are very 
fond of sitting opposite to blazing fires with child- 
ren on their laps, as the flames divert and prevent 
them from being troublesome: but this practice 
should be absolutely prohibited, as the origin 
of many complaints, and especially those of the 
eyes. 



68 TREATMENT OF INFANTS 

It is indeed of the greatest consequence to 
protect all the senses of young infants from being 
offended by too strong excitements, particularly 
of a disagreeable nature. They should be guarded 
against all loud and harsh noises, rough handling, 
powerful smells, and nauseous or pungent tastes; 
but above all things, the sense of sight should 
be treated with the greatest delicacy, as it ;s the 
most important, and the most liable to injury. 



CHAT. IV. 



ROOMS INHABITED BY INFANTS — MANNER OF HOLD- 
ING THEM — or GIVING THEM FRESH AIR. 

The room inhabited by an infant should be 
neither small nor low: it should have a good chim- 
ney, not liable to smoke; and should be kept 
particularly clean. No foul linen, dirty vessels, 
or remains of food should ever be left in it; nor 
should any persons sleep there, except those ne- 
cessary to attend on the child. The candles burnt 
in a nursery should be particularly free from bad 
smells, and the night-light as small as possible. 
When the bed-room is washed, the child should 
be removed into another for the night; unless in 
the heat of summer, when, by having the floor 
washed with boiling water early in the morning, 



TILL AFTER TWO MONTHS OLD. 69 

and the windows left open for several hours, 
it will probably be quite dry before evening. 
There is nothing more necessary to guard against 
than dampness, which has occasioned the death 
of many infants. When children are not accustom- 
ed to it, it gives them cold; and when they are so 
used to it as not to be affected in this manner, it 
often produces still worse consequences. The 
over-cleanliness of washing rooms in bad weather, 
where children are obliged to sleep, has often done 
irreparable injury. 

The manner of holding a young child is a matter 
of no small importance, as the foundation of mal- 
adies depending on the internal structure, may be 
laid within the first weeks of its existence; and 
some careless or awkward mode of handling it at 
this time, may be the occasion of future disease 
or deformity. By being held always on the same 
arm, an infant may easily be made crooked; by 
always being put to sleep on the same side, a 
similar effect may be produced: but these are 
trifling in comparison with the harm which may 
be done by making a child sit up, before its neck 
is strong enough to support the weight of its head. 
When infants are robust and well proportioned, 
they may perhaps escape injury, notwithstanding 
the manner in which many nurses choose to hold 
them sitting up, before they are able to keep their 
heads erect; but if a child happens to have the 
head a little too heavy, or the spine a little too 
weak, it is impossible to calculate the extent of 
evil which may be produced by a foolish attempt 



70 TREATMENT OF INFANTS 

to force it too soon into the most unnatural and 
unwholesome posture to which the human frame is 
habituated. The best way to avoid this danger, 
is not to cause an infant to sit up at all till after 
two months old, but always to support it (either 
when on the lap or in the arms) in a reclining 
posture, with the hand or arm behind its neck, 
so as never to let the head hang forward or fall 
back. 

These may appear to many unnecessary, and 
perhaps absurd precautions, since we have often 
seen children grow up very healthy and free from 
all the dreaded evils, who have been made to sit 
up, witli their heads hanging like flowers too heavy 
for their stalks: but we have also seen many die 
of unknown maladies, and of convulsions, the 
causes of which were not apparent, and which may 
possibly have proceeded from some injury to the 
spinal marrow, unobserved, and irremediable if it 
had been observed. When we consider the num- 
ber of infants who perish in the first two months 
of their existence, it is surely well worth the atten- 
tion of a mother to prevent even the most remote 
cause of harm to their delicate frames. There is 
the same reason for avoiding to make children sit 
up, as there is for not swathing them like Egyp- 
tian mummies, in the manner customary in so many 
parts of Europe: the greater number of those 
who have been dressed in this way, are as straight 
and well made as those who have not; but the 
practice is better to be shunned, on account of 
the injuries which may, and sometimes do, happen 



TILL AFTER TWO MONTHS OLD. 71 

in consequence of it. Children will by degrees 
acquire strength to hold up their heads, and some 
much sooner than others; but it is better not to 
run risks by anticipating the progress of nature 
when it may be retarded without danger. 

Though infants should not be taken out till after 
they are a month old, as the open air can afford 
them no advantage or amusement, and may do 
them harm before that age; yet the atmosphere 
of their rooms should be constantly changed, and 
in suitable weather the windows ought to be left 
open for a quarter of an hour every day. The 
child should be taken into another room during 
this time, and not brought back to its own, until 
the air has been warmed again by the fire. Of 
course this is to be understood of a child in good 
health: in cases of illness, every thing must be 
conducted in a different manner. It is scarcely 
necessary to say, that in dry, warm weather, the 
windows of a nursery should be often opened dur- 
ing the day ; the hours being adapted to the season 
and climate. 

Infants should be brought by degrees to endure 
the cold air, as any sudden transition is injurious 
to them. Those born in winter require particular 
attention: they should not be taken out so soon 
as those born in summer; and it would be better 
to have the air of their rooms kept warm, than to 
load them with heavy clothing. 

It should always be remembered that it is by no 
means safe to take young children into the open 
air too soon. Until a month old they can scarcely 



72 TREATMENT OF INFANTS 

derive any advantage from going out; and, even 
after that age, it should depend on the time of 
year and the. country where they are born. The 
pleasure they begin to show on being taken out at 
five or six weeks old, proves that exercise in the 
free air is then good for them ; and, therefore, if 
the weather be fine, they should enjoy it every 
day ; but with their bodies sufficiently covered to 
prevent them from feeling cold, and their eyes 
carefully guarded against the impression of strong 
light. As soon as the child shows any fatigue or 
uneasiness, and especially if it appears to surfer 
from cold, it should be brought into the house ; 
and in damp weather, children under two months 
old should not be taken out at all. 



CHAP. V. 

INFANTS OUGHT TO HAVE THE MOTHERs's MILK IS 

SOON AS POSSIBLE MEDICINE SELDOM NECESSARY 

WANT OF APPETITE MUCUS IN THE STOMACH 

HANDLING GENTLY HOW THE HEAD SHOULD 

BE CLEANED. 

It is a very common and hurtful practice to 
prevent the new-born babe from sucking, until the 
mother's milk is come (as it is called) that is to 
say, until the woman is oppressed by the accumula- 



TILL AFTFR TWO MONTHS OLD. 73 

tion of this fluid, and the breasts consequently dis- 
tended to a painful degree. In this state, the 
child finds great difficulty in obtaining its nourish- 
ment, and, if weak, is utterly incapable of draw- 
ing it: the vain efforts fatigue and put it out of 
humor, and the nipples of the mother become 
sore by the useless irritation of the child's gums. 
All this trouble would probably be avoided by 
putting the infant to the breast in a few hours after 
its birth; when it would procure a small quantity 
of milk at a time, the purgative quality of which 
would assist the evacuation of the meconium, and 
prevent the necessity of medicine; while the 
mother's breasts would fill by slow degrees, 
and escape that painful swelling which results 
from not allowing the child to suck as soon as it 
ought. 

The custom of purging infants as soon as they 
are born, may often be attended with bad conse- 
quences. If the child is to have the advantage 
of being suckled by its mother, the first milk will 
probably be found sufficient to clear off the black 
substance contained in the bowels: and in all 
cases a certain time should be allowed, to let it 
appear whether nature be adequate to the per- 
formance of this office. Instead, therefore, of 
administering a dose of physic to a child in the 
first hour of its existence, it would be better, when 
there are no great symptoms of uneasiness, to 
wait many hours before this expedient is resorted 
to. It is not impossible that the retention of the 
meconium for a certain time after the birth, as well 



74 TREATMENT OF INFANTS 

as the evacuation of it by slow degrees, might 
contribute to prevent those pains in the bowels, 
so well known under the name of gripes; and that 
the length of time this ought to remain, varies 
according to the individual circumstances. But 
in this, as in many other important matters, nature 
is not consulted; every constitution is to be cut 
down to the same measure, and all are to be in- 
discriminately purged in the same manner and 
with the same quantity of medicine. 

When a child is not destined to have the bene- 
fit of its mother's milk, it is sometimes necessary 
to give some assistance in clearing the bowels of 
their first contents: and substances not positively 
of a purgative nature might often be found suffi- 
cient to produce the desired effect. A little 
brown sugar or honey, mixed in a spoonful of 
warm water or thin gruel, would frequently an- 
swer the purpose as well as any thing else; but 
as these do not usually come out of an apothe- 
cary's shop, they are seldom supposed to be ad- 
equate to the purpose. If a mcdicinal # substance 
is really found to be necessary, a little magnesia 
and rhubarb, or cither of these alone, in a spoon- 
ful of warm fennel-water, with enough of white 
sugar to make it agreeable to the taste, will pro- 
bably prove effectual. What might be still better 
is a tea-spoonful of the syrup of Endive, mentioned 
in the Appendix to this work. These are prefer- 
able to oil of sweet almonds, castor oil, or manna, 
which have been employed for the same purpose. 
Oily medicines, when they do not perfectly sue- 



TILL AFTER TWO MONTHS OLD. 75 

ceed in purging, are injurious; and manna de- 
ranges the stomach more than is necessary. 

When circumstances render it expedient for 
an infant to have milk of three or four months 
old, one of the chief precautions to be taken at 
first, is not to let it suck much at a time. Not- 
withstanding the facility with which young child- 
ren vomit, they are by no means secure from in- 
digestions; a species of indisposition very likely 
to occasion convulsions, the danger of which 
every one knows. 

If a new-born infant shows a desire for food (as 
sometimes will happen) before it is convenient 
to put it to the breast, a spoonful or two of warm 
fennel-water, with a little sugar, will probably 
satisfy it and be the safest thing it can have. 

When a healthy child will not suck in twenty- 
four hours after its birth, the cause must be ex- 
amined into, as it is likely that there is some sub- 
stance in the stomach which must be evacuated, 
either naturally or artificially, before the infant can 
acquire the appetite which it ought to have. This 
is one of the cases where it may be necessary to 
employ purgatives or emetics, respecting which 
the attendant physician should be consulted, 
as something more active than the common 
remedies may be wanted to produce the desired 
effect. 

When it appears that a young infant has agreat 
deal of mucus in the stomach, it should not be 
left an instant alone, as examples are not want- 
ing of children who have been suffocated in their 



76 TREATMENT OF INFANTS 

sleep by an accumulation of this substance, which 
they were unable to throw off while lying down. 
And for this reason, amongst others, an infant 
should never be laid on its back, but alternately 
on each side ; and for the first few days it should 
never be left half an hour in its bed or cradle 
without being looked at. 

By great attention in the manner of handling 
and dressing children during the first weeks of 
their existence, not shaking them about unne- 
cessarily, not interrupting their sleep, nor suf- 
fering the cold air to strike on their stomachs and 
bowels; I am convinced that many of their early 
maladies might be prevented. But the women 
who are employed about them, in the first period 
of their lives, often take no care to avoid rough 
and abrupt movements in handling them: and, in 
particular, make no scruple of rousing them from 
sleep for the purpose of washing and dressing; 
not seeming to be at all aware that a sort of dis- 
turbance, which would derange the nerves of a 
delicate adult, must have a still worse effect on 
the more tender frame of a young- infant. .\ Gl- 
are they by any means sufficiently exact in pro- 
tecting from cold the body of the child, which 
should not remain for a moment uncovered with- 
out being gently rubbed by a warm hand. 

It is an imprudent act of cleanliness to remove 
all at once the scurf which sometimes gathers on 
the head and even spreads over the forehead of very 
young infants; and this is probably one of the rea- 
sons why we often see the children of persons in 



TILL AFTER TWO MONTHS OLD. 77 

easy circumstances tormented, just after their birth, 
with that troublesome stuffing in the head which is 
in some places vulgarly called the snuffles. When 
the infant is somewhat inured to the external air, 
at two months old, or later, (according to the sea- 
son of the year,) whatever scurf adheres so firmly 
to the head as not to come off in washing, may be 
safely and effectually removed, by rubbing a little 
butter on a small part of the head one day and 
cleaning it with a boxwood comb the next, before it 
is washed: then a little more butter should be 
rubbed on another part of the head which should 
be cleansed in the same manner the day after; and 
in thus removing the scurf by degrees, the head be- 
comes clean in a very short time, without any 
danger of cold. In many places the lower class 
have a prejudice against removing the scurf from 
their children's heads at all, waiting till it comes off 
of itself; but this is also an error, and leads to 
many of the bad consequences of dirt, as they 
neglect to wash the head, which should be done 
every day as long as the scurf is suffered to remain. 
When the head is once perfectly clean, the best 
means of preserving it in this state is by a brush, 
which should at first be soft, and as the child ad- 
vances in age, should be changed from time to 
time for one harder. The seldomer a fine comb is 
applied to the head of an infant, the better, and on 
no account should those of ivory, bone, or tortoise- 
shell be ever used; for, even when they do not 
wound the skin and produce a sore (as frequently 
happens,) they are very likely to augment the 



78 TREATMENT OF INFANTS 

production of that substance they are intended to 
remove. But I shall return to this subject again 
when I have to treat of children more advanced 
in age. 



CHAP. V 



INTERNAL TAINS — CRYING COSTIVENESS — STRAN- 
GURY— BECOMINt; THIN — DISTORTIONS OF FACE. 

The first maladies of infants (which arc in a 
great measure the effects of imprudence) may 
be rendered much lighter by immediate remedies: 
and many pains in the stomach and bowels re- 
lieved in the first moments, by the mere appli- 
cation of heat and a slight pressure. Every old 
nurse knows by experience that it is often possi- 
ble to tranquillize a young child in a violent fit of 
screaming, by only laying it on its belly across her 
knees, and while she gently moves it back and 
forward, patting it softly on the back with her 
hand. This in the first moments of pain, will of- 
ten be found sufficient to produce a discharge 
of the wind which occasioned its uneasiness, and 
prevent further bad effects; but if, through laziness, 
or a notion that young children ought to cry, 
this is neglected until the duration of pain has oc- 
casoned either convulsions or inflammation, no 



TILL AFTER TWO MONTHS OLD. 79 

advantage can be expected from it, and recourse 
must be had to medical treatment. 

The crying of an infant should never be dis- 
regarded: it is the sign of some pain, or some 
want which ought to be attended to. The cry 
of hunger is that easiest to be understood by the 
person who suckles the child, and when there is 
no reason to suppose that its uneasiness proceeds 
from this cause, it should not be put to the breast, 
but other expedients should be tried to tranquil- 
lize it; such as rubbing the stomach and the 
bowels with a warm hand, placing the infant 
gently in different postures, stripping it to exam- 
ine if any part of its clothing may have hurt it, 
and giving it a little motion in its cradle or on 
some one's, knees; taking great care, however, 
that no abrupt or violent movement be employed. 
When the inquietude does not proceed from dis- 
ease, these expedients will generally be found suf- 
ficient to restore its tranquillity. In such cases, 
however, the evacuations of infants should al- 
ways be observed; and if there is any thing ex- 
traordinary or irregular in them, the appropriate 
remedies should be applied. 

New-born infants are sometimes affected with 
an obstinate cosliveness, which, if not attended to 
in time, is likely to produce fever and convul- 
sions. When a child who has not evacuated the 
meconium appears uneasy, it should have some 
laxative medicine; and if this does not produce 
the desired effect, a clyster should be administer- 
ed. Brown sugar and warm water, with the 



80 TREATMENT OF INFANTS 

addition of a little good oil or barley-water, with 
a little honey, may answer this last purpose as well 
as any thing else. Should this treatment not 
prove sufficient to remove the child's uneasiness, 
it would be expedient to try a tepid bath, before 
any stronger remedies are resorted to: but if that 
fails, a physician should be immediately consulted. 
For no very active medicine should ever be given 
to an infant without the advice of a professional 
man, to whom all that has been already done for 
its relief should be accurately detailed. 

New-born infants are also subject to a retention 
of urine, for which the tepid bath is likely to be 
the best remedy; and, if the child has not yet 
been put to the breast, a spoonful or two of fen- 
nel-water may also be of use. When this reten- 
tion, or a difficulty in passing the urine, occurs 
in a few weeks after the birth, it is sometimes less 
easy to remove; but in this case too the bath 
should be tried, or warm fomentations, (with 
chamomile, elder flowers, or onions,) over the 
lower part of the belly, and the bowels should be 
cleansed by means of a clyster: when this is done, 
a tea-spoonful of syrup of white poppies,* with 
one drop of spirit of hartshorn, mixed in a large 
spoonful of warm water, may be given to the 
child. But if these remedies are not found 



* This is a medicine which should never be got from any 
but a respectable apothecary, as it is not always prepared 
as it should be ; and when it is not, may produce danger- 
ous effects, instances of which I have known. 



TILL AFTER TWO MONTHS OLD. 81 

sufficient, medical assistance should be sought 
without further delay. 

It sometimes happens that a child born with the 
appearance of being very fat, falls away extremely 
in a few days after; but when there is no symp- 
tom of disease, when the appetite, sleep, and 
evacuations are all natural and regular, there is 
no cause for uneasiness about the infant's health, 
as will soon be evident by the manner in which 
it thrives after some weeks. A young mother 
should therefore be on her guard, not to let her- 
self be persuaded (as has sometimes happened) 
that her milk disagrees with her child; nor should 
one who has a hired nurse, be induced to form an 
unfavorable opinion of her on this account: and, 
if no marks of indisposition appear in the infant, 
no disadvantage can result from the delay of a 
month or five weeks; and in this time the real 
state of the case will appear. 

Mothers have no reason to be alarmed at 
the distortions of the face, or irregular breathing 
of new-born infants, as there are none free 
from these effects of the extreme sensibility of 
their nerves; and, if not accompanied with any 
symptom of disease, they are of no importance. 
When, however, a very young child is observed 
to smile often in its sleep, it should be watched; 
and if it should awake suddenly, crying and draw- 
ing up its legs, these are signs of some pain in 
the bowels, for which relief should be sought. 
This pain, however, may be so slight, that rub- 
ing the belly gently with a warm hand, turning 
5 



82 TREATMENT OF INFANTS 

the child on its face across one's knees, or merely 
changing its position, may be sufficient to remove 
or send away the wind which has disturbed its 
repose. 



CHAP. VII. 

JAUNDICE RED GUM HICCOUGH LOOSENESS 

GRIPES. 

Many children have the jaundice very soon 
after their birth; but this malady, when occa- 
sioned by no organic defect, is of little conse- 
quence, and either passes away of itself, or yields 
to the use of some mild purgative. Should it 
continue obstinate after the administration of gen- 
tle remedies, a physician should be consulted. 

The red gum is a slight disease extremely com- 
mon amongst new-born infants, and often con- 
tinues for several weeks; its general character 
is so well known, that it is scarcely necessary to 
say it appears in small red pimples, which come 
in blotches, chiefly on the face and arms. But, 
it sometimes happens (especially in hot weather) 
that it assumes an appearance which alarms those 
who have never seen it before in that shape, and 
which, therefore, I think it right to mention more 
particularly. The eruption is very abundant on 
all parts; and some of the spots grow large and 
suppurate, running into each other, and forming 



TILL AFTER TWO MONTHS OLD. 83 

an irregular sort of pustule, that appears to pen- 
etrate below trje skin, and threatens to leave a 
mark, which however it does not. The best 
remedy for this malady is a tepid bath, com- 
posed either of milk and water, or of water in 
which some bran has been boiled. In this the child 
may remain about ten minutes : and here I must 
again urge the extreme caution requisite in the use 
of warm baths, which when employed by awkward 
or careless persons, may be the occasion of more 
mischief than advantage. The room in which 
the bathing-vessel is placed should be moderately 
heated; the cloths for drying the infant, of a con- 
venient warmth; and while one person lifts it 
out of the water, another should be ready to cover 
it instantly, so that it may be in no danger of 
suffering from the comparative cold of the sur- 
rounding atmosphere. 

A child should not be put into the bath either 
immediately after sucking, or when it appears to 
be very hungry. As soon as it is well dried and 
covered, it should be put to the breast; when it 
will probably suck eagerly, and then sleep qui- 
etly for some time. 

The bath diminishes .the irritation and uneasi- 
ness produced by the eruption, cleanses the pores 
of the skin, and promotes the perspiration requi- 
site to carry off the disease. If (as generally 
happens) the malady is combined with derange- 
ment of the stomach and bowels, in consequence 
of acidities, it will be right to give a few grains 
of rhubarb and magnesia (two or three of each,) 



84 TREATMENT OF INFANTS 

mixed in a little fennel-water, with a sufficient 
quantity of sugar to make the child swallo^ it 
without disgust: for, even at that early age, what- 
ever is taken unwillingly is less beneficial than 
it might be. This should be repeated if it does 
not purge in a few hours, and the quantity in- 
creased if necessary; as it is only by experience 
we can learn what dose is required for different 
constitutions, and it is always right to begin with 
small quantities, when not under the direction 
of a medical man. 

If, after the warm bath has been used, and the 
evacuation produced by the medicine has been 
sufficient, the child should still continue uneasy 
and restless, a small tea-spoonful of syrup of 
white poppies may be given al night. Tins treat- 
ment will generally be found sufficient to abate 
the disease; but should it not, the purgative 
medicine may be repeated in a day or two; and 
a repetition of the bath may also be expedient, if 
the eruption be not diminished by the first appli- 
cation of it. 

Any other sort of eruption than the above-men- 
tioned, appearing on an infant under two months 
old, would render the immediate advice of a phy- 
sician necessary; especially if the child has a 
hired nurse, as a very different treatment might 
be required, which nothing but a medical exam- 
ination into the particular circumstances of the 
case could determine. 

Many infants vomit frequently; but if it be 
with great ease, and the milk be thrown up cur- 



I 



TILL AFTER TWO MONTHS OLD. 85 

died, it is of no consequence, especially in the 
first two months: it is, however, better that 
children should not vomit; and I have good rea- 
son to think that those who are suckled by their 
mothers, are less liable to this inconvenience than 
those who have hired nurses. 

The hiccough in young infants may generally 
be stopped by a little powdered sugar, or a few 
drops of cold water. If their breasts are well 
covered, they will not be liable to it, as it is fre- 
quently occasioned by the impression of the cold 
air on that part, 

Most people are aware of the necessity of at- 
tending to the state of the bowels in young child- 
ren; but many of those intrusted with the care of 
them, do not know that in nineteen cases out 
of twenty, the way to cure a looseness is by the 
administration of a purgative medicine. Indi- 
gestion, acidities, and superabundance of bile 
may be causes of the complaint, and till the sub- 
stance which offends is carried oft", the malady 
cannot be removed. Nurses are apt to believe 
that children who take no other food than their 
?nilk cannot suffer from indigestion ; but this is a 
great mistake, as nothing is more likely to oc- 
casion that complaint, than milk in too great a 
quantity, or of a quality that does not accord 
with the stomach of the child. In case of too 
great a discharge from the bowels, let the cause 
he what it will, there are no safer medicines than 
those I have already mentioned: the quantities 
being increased according to the age of the in- 
fant, and other circumstances. 



86 TREATMENT OF INFANTS 

It is a common saying amongst old nurses, that 
"the strongest children are those who have gripes 
till three months old, for they suck the more and 
thrive the better. " This is a dangerous prejudice, 
and frequently prevents maladies from being suf- 
ficiently attended to. Jlmj appearances of pain or 
uneasiness in an infant should be immediately ex- 
amined into, and means sought to remove llum. 
Their evacuations should be observed: and when 
they have a sour smell, a little magnesia should 
be given now and then, mixed in fennel or weak 
mint-mater, with half a grain of rhubarb. Slimy, 
frothy stools, should be treated in the same man- 
ner, only increasing the quantity of rhubarb and 
diminishing that of magnesia. When a child has 
a great deal of wind without any wrong appearance 
in the evacuations, the fennel or mint-water may 
be given alone, or two drops of spirit of hartshorn 
in a spoonful of warm water and sugar. The 
stomach and bowels may be rubbed now and 
then with brandy or camphorated spirits, which 
can be sufficiently heated by putting the bottle 
which contains them into a basin of warm water: 
in applying this however, great care must be 
taken lest a drop of it should fall on any part where 
the skin is particularly tender; for any thing that 
makes a child cry is likely to increase this com- 
plaint. But the chief thing to be attended to, 
both for the prevention and cure of gripes, is the 
manner of putting on and off the child's clothes; 
as I am fully convinced that the principal part of 
these sort of maladies is occasioned by the cold 



TILL AFTER TWO MONTHS OLD. 87 

air striking on the stomach and bowels, through 
carelessness in washing and dressing infants. 

In regard to the assertion so often made, that 
there are no stronger, finer children, than "those 
who are constantly griped during three months," 
it is easily explained. Infants who are able to 
support continual pain, and the inattentions by 
which it is probably occasioned, for so long a time, 
without some dangerous disease, must have very 
strong constitutions and a great propensity to thrive, 
which enables them to resist all the dangers that 
surround them: whereas children of delicate frames 
are thrown into covulsions by similar causes, and 
either sink under the malady, or are saved by 
the skill of the physician, who in such cases must 
have some authority. 

When a child not suckled by its mother, is con- 
stantly troubled with gripes, the nurse's state of 
health should be inquired into, her milk examined 
and her diet altered or medicated according to 
circumstances. 



CHAP. VIII. 



COLD IN THE HEAD SORE EYES COLDS AND 

COUGHS ACCIDENTAL SORE MOUTH THRUSH. 

Young children are often afflicted, even in the 
first month, with a troublesome cold in the head, 
which hinders them from breathing through the 
nose, and renders sucking difficult and painful to 



88 TREATMENT OF INFANTS 

them. For this complaint (which is usually the 
effect of great negligence or over-cleanliness) it 
might be useful to bathe the feet in warm water 
with salt in it, for about ten minutes; using the 
same precautions in drying which are recommend- 
ed after the entire bath, and then wrapping them 
up in warm flannel. The best time for doing this 
is before the child goes to sleep, on account of the 
feet being well covered; but, if that should not be 
convenient, it will be easy at all times to keep the 
feet of an infant sufficiently warm. The top of 
the head ouglit perhaps to be covered a little more 
than usual, if the weather be cold, especially at 
night; and the old nurse's practice, of rubbing 
grease on the bridge of the nose and between the 
eye-brows, should not be forgotten. 

If, in consequence of a cold in the head, a 
young child should have sore eves, the mother's 
milk will generally be found the best application. 
She should milk her breast on the eyes, so as to 
let the liquid run into the corners, every time the 
lids are fastened together, or the eyes filled with 
glutinous matter. If this remedy and a dark room 
are not sufficient to cure the malady in a few 
days, it will require the advice of a physician: 
and, more particularly, if the child have a hired 
nurse. 

Colds and coughs, in the first stage of infancy, 
generally proceed from carelessness or ignorance 
in the persons who are entrusted with the care 
of children: either by exposing them to currents 
of wind, putting on their clothes not sufficiently 



i 



TILL AFTER TWO MONTHS OLD. 89 

aired, leaving the bosom uncovered in cold 
weather, or dressing them so awkwardly as to 
keep them longer naked than is necessary. It 
would be difficult to specify half the causes, or 
detail half the instances of inattention which oc- 
casion the maladies of infants; but I am thorough/ 
convinced that much of pain and misery, after- 
wards, might be traced to these sources. 

When it appears that a young child has caught 
cold, the greatest care should be taken to keep 
the air about it of an equal and moderate temper- 
ature; for which reason it should not be carried 
from one room to another, through passages and 
staircases. If there be cough or difficulty of. 
breathing, the feet should be bathed, as before 
directed for a stoppage of the nose, and if there 
is reason to suspect any soreness in the throat 
(which may be discovered by the sound of the 
voice) a piece of fine flannel should be put round 
the neck, and the chest, also, covered with the 
same from the throat down to below the pit of the 
stomach; these two bits of flannel being sowed 
together in the form of a T.* But if this should 
occur in the autumn or winter season, to a child 
of six or seven weeks old, and especially if the 
cough be severe, it would be prudent at once to 
put on a flannel waistcoat next the skin, which 

* An onion poultice is often tried with great advantage. 
Stew the onions in goose-oil, sew them in a bag and apply 
them to the chest. This poultice has been tried with bene- 
fit on a child three weeks old ; for older children, apply the 
onions to the feet after bathing them. Am. Ed. 



90 TREATMENT OF INFANTS 

might perhaps prove the most effectual remedy. 
It should be made of the thinnest, softest mate- 
rials; should fasten behind, and cross over at least 
an inch and a half. It should not be left off as 
soon as the malady is cured, but be continued till 
the warm weather, and then cut away by a little 
strip at a time, so as to accustom the child by de- 
grees to do without it. Infants who wear flannel 
next the skin should have many changes of it, 
and great care should be taken to wash it well, or 
it will grow hard and loose much of its warmth. 

In case of a hard cough, equal parts of syrup 
of squills and of mucilage of gum arabic may be 
mixed together, and given in the quantity of a tea- 
spoonful three or four times a day; and, if this 
should make the child vomit, it will do no harm: 
indeed if the cough be accompanied with a wheez- 
ing sound, and there is the appearance of much 
mucus in the chest, the properest remedies are 
those which produce vomiting. When this is 
required, half a grain (or more as may be found 
necessary) of ipecacuanha powder may be given 
in a tea-spoonful of simple syrup, or of sugar and 
warm water, just before the child sucks, and re- 
peated according to the effect it produces. This 
quantity is for a child of five or six weeks old; to 
one of as many months, a whole grain may be 
given at first, and increased if that quantity should 
not answer the purpose, which however it gener- 
ally does, if the medicine be good, and the child 
be put to the breast immediately after taking it. 
It is of much importance that the feet of an infant 



TILL AFTER TWO MONTHS OLD. 91 

who has a cough be kept warm, and therefore 
great care must be taken to have them constantly- 
covered. 

In giving any medicine to a very young child, 
attention should be paid to let it swallow very 
slowly, for fear of exciting a cough; and when 
there is any powder to be taken, the person who 
gives it should stir the liquid the whole time the 
infant is swallowing, that the powder may go down 
by degrees, and not remain in the bottom of the 
spoon to stick in its throat at the last. After the 
child has vomited sufficiently to relieve the diffi- 
culty of breathing, and the other symptoms of the 
chest, a little syrup of white poppies may be given 
at night in the same manner as directed in treat- 
ing of the red gum. 

This method of cure will generally remove or 
much diminish an infant's cold in a few days, but 
if it does not, I know of nothing else which should 
be done without medical advice; and would re- 
commend consulting a physician immediately, lest 
bleeding or blistering might be necessary, or the 
apparent cold be only the symptom of some other 
malady. I shall return to the subject of colds 
when I come to treat of the diseases of children 
of more advanced age. 

If for any reason it should be necessary to feed 
a new-born babe, great care must be taken that 
the food be not too hot. Wooden boats or ivory 
spoons are to be preferred to silver, because they 
do not retain so much heat, and have not such 
sharp edges; in every thing that is to be done for 



92 TREATMENT OF INFANTS 

children by servants, the causes of offence should 
be removed as far as possible ; and though a ten- 
der mother or experienced nurse might be so 
careful in the manner of using the boat or spoon 
as to render the materials they are composed of a 
matter of indifference, it is by no means the same 
with regard to all persons employed about infants. 
Any thing a little too hot, or any sharp edge touch- 
ing, too roughly, the mouth of a very young child, 
may occasion sores which sometimes become very 
troublesome, and continue a long time. If such 
a malady should appear, the best remedy is borax 
finely powdered, and mixed with the best honey 
that can be got, in the quantity of one tea-spoon- 
ful of the former to about tlirce of the latter; a 
very liltle of this gently applied with the finger to 
the spot which is sore, four or five times a day. 
will generally effect a cure very soon, when the 
complaint proceeds from such causes as those 
above-mentioned. If, after a kw days' trial, this 
remedy is found of no use, it will be right to con- 
sult a physician without delay, lest the malady 
should be of some other nature, and require dif- 
ferent treatment. 

There is a disease called the thrush (aphtha,) 
which in its mild state appears very like the 
above-mentioned accidental indisposition, but is 
usually accompanied with some derangement of 
stomach or bowels. It begins with small white 
blisters on the tongue and inside the mouth; and 
if attended to immediately, is sometimes very easy 
to cure; but if neglected, may soon extend the 



TILL AFTER TWO MONTHS OLD. 93 

whole length of the stomach and bowels, and be- 
come a very dangerous disease. While the blis- 
ters are white, and the child has no fever, nothing 
more will be necessary than to apply, frequently, 
the borax and honey, as before directed. Should 
there appear any uneasiness in the throat, or in 
breathing, a little ipecacuanha may be given to 
procure slight vomiting; and in case of sour 
smelling stools, or too many of them, a sufficient 
quantity of rhubarb and magnesia* to purge 
gently; for this is a malady in which none but 
very mild remedies should be given, except by 
the order of a physician who has examined the 
particular circumstances of the case. Should the 
treatment here directed produce no good effect, 
and the spots change their color, it would be 
proper to apply for medical advice, as this is a 
disease which may very soon end fatally; and 
should it be an epidemic malady (as it often is) 
the professional man will be best able to deter- 
mine what remedies are most likely to prove bene- 
ficial, in that particular season. 

The best way to guard against this disease, is 
to take care that the child does not get milk heat- 
ed by too full living, over exercise, &c. As soon 
as it is perceived, the mother or nurse should 
drink plentifully of rice water, or other diluting 
liquors, and all her food should be of a more cool- 
ing nature than before, at the same time that she 

* The quantities of medicines, proportioned to different 
ages, will be found in the Appendix. 



94 TREATMENT OF INFANTS 

should not make too great a change in her diet. 
If the child has a hired nurse, the state of her 
health and quality of her milk should be particu- 
larly examined, lest there be something in it un- 
suitable to the constitution of the infant. It is 
however, to be observed, that the mild sort of 
thrush is not unfrequently produced by teething, 
and when a child ! s mouth, jn sucking, feels very 
hot to the breast, it would always be right to look 
whether there are any blisters in it. Nothing is 
better to prevent this kind of thrush than washing 
the mouths of infants with cold water, several 
times a day, in the manner already advised. 



CHAP. IX. 



CONVULSIONS THEIR VARIOUS CAUSES, AND THE 

MANNER OF TREATING THEM. 

More children are destroyed during the first 
two months by convulsions than by any other mal- 
ady. They are produced, at all ages, by a vari- 
ety of causes, but the younger the infant, the more 
slight may be the occasion of the disease, and 
the more difficult to discover. When caused 
by an organic defect, they generally end fatal- 
ly in a short time, which may be considered as 
a fortunate circumstance; for any mal-confor- 
mation sufficient to produce such effects, must 



I 



TILL AFTER TWO MONTHS OLD. 95 

ever prevent the well-being in mind or body of the 
individual so born. But many accidental cau- 
ses occasion convulsions, which are easily cured 
by proper treatment. 

It is sometimes difficult to discover the imme- 
diate cause of a fit of convulsions, in a very 
young infant; but as the remedies in the first 
instance are the same, let the malady proceed 
from what it may, this is not a matter of very great 
importance. The first remedy to be tried, in all 
attacks of convulsions, is the tepid bath, in which 
the whole body of the child should be immersed 
up to the neck; but if a sufficient quantity of 
water for this purpose cannot be immediately 
procured, and there is at hand as much only as 
will serve to bathe the feet and legs, it is better 
to make use of that without delay; as warm 
water applied to the extremities will sometimes 
answer the purpose of checking the convulsive 
movements. 

As soon as the fit of convulsions is over, means 
must be used to prevent a return, and for this 
purpose, it is necessary to examine as far as pos- 
sible into the cause which may have excited them. 
This will frequently be found in some derange- 
ment of the stomach or the bowels, for which a 
purgative medicine is the best remedy. Should ' 
the child be naturally of a costive habit, it will be 
better to begin by giving a clyster with oil, ho- 
ney, or brown sugar; and care must be taken to 
keep the bowels sufficiently free afterwards by 
some mild purgative medicine. For this the 



96 TREATMENT OF INFANTS 

syrup of endive, directed in the Appendix, will be 
fo«nd well adapted, as well as in most cases 
when it is necessary to purge young children. 

When there is reason to suppose that convul- 
sions have been occasioned by indigestion, acidi- 
ties, bile, Sec. the purgative medicine should be 
given immediately, without waiting to administer 
a clyster, as the danger of the malady returning 
can only be prevented by carrying out of the 
stomach, as quickly as possible, the acrimonious 
and offensive substances which may have produc- 
ed it. When the child has been sufficiently purg- 
ed, and the stomach and bowels appear to be 
thoroughly cleansed, a tea-spoonful of syrup of 
white poppies may be given with good effect. It 
is to be observed, however, that this medicine 
does not agree equally well with all stomachs, and 
will sometimes make infants vomit. When this 
is found to be the case, it will be better to give 
two or three drops of Hoffmann's anodyne liquor 
in a spoonful of fennel-water. 

If a child be much troubled with wind, as 
usually happens after a complaint in the bowels, 
and especially when convulsions have been sus- 
pected to have arisen from that cause, a kw drops 
of tincture of rhubarb, in a spoonful of mint or 
of fennel-water, may be given once a day till the 
complaint be removed. Rhubarb, in all shapes, 
is by far the best medicine which can be given to 
young children; and by increasing or diminishing 
the quantity, and varying the mode of preparation, 
it can be made purgative or tonic. The only ob- 



TILL AFTER TWO MONTHS OLD. 97 

jection to it is, the very disagreeable taste, and 
there are ways of disguising this, which should 
never be neglected ; for the less uneasiness of body 
and mind to which we subject children, the better. 

But with respect to convulsions, the causes 
above-mentioned, though the most frequent in the 
first two months, yet, are by no means all which 
are to be dreaded. Infants have been seen to re- 
cover immediately from violent convulsions on 
being undressed, when it has been discovered that 
pins have run into some part of their delicate 
bodies, or some articles of their clothing have been 
too tight. But if the advice given in this work 
be attended to, it will be impossible for these causes 
to exist. 

Another very probable cause of convulsions is 
the red gum, or any other eruption, being driven 
from the surface of the skin by the effects of cold; 
but the greatest care should be taken to avoid this 
cause; and should it occur, the warm bath is the 
proper remedy: and one or two drops of spirits 
of hartshorn may be given in a little warm water 
and sugar. 

I shall return to this subject again in another 
part of this work. 

Though worms have been met with in child- 
ren under two months old, yet it has been so 
rarely, that I do not think it comes within the 
scope of my plan to consider this as one of their 
diseases; and any circumstance so extraordinary 
should certainly be a reason for consulting a phy- 
sician immediately 
G 



98 TREATMENT OF INFANTS 

Infants under two months old, though not free, 
from danger of epidemic and contagious diseases, 
yet are less liable to them than those more ad- 
vanced, and therefore I do not consider this as 
the proper place to treat of such maladies, but 
shall proceed to mention an important subject 
which belongs to this part of my work.* 



CHAP. X. 

BRINGING UP CHILDREN WITHOUT HUMAN MILK. 

When a mother cannot suckle, and no proper 
nurse is to be found, a healthy child may be safely 
brought up without the breast: and if great atten- 

" To many persons it may appear, that in saying so much 
about the cure of diseases, the author transgresses the bounds 
she had prescribed to herself; but on examination it will be 
found that this is not the case. She would always recom- 
mend those whose circumstances enable them to procure the 
assistance of a really skilful physician, to profit by his ex- 
perience even in trifling maladies ; but as this book is de- 
signed for mothers in every rank of society; many of whom 
live at a distance from medical aid, and others only on ex- 
traordinary occasions can afford the expense attendant on 
having good advice, it is but just to point out to such per- 
sons the means of curing slight indispositions, and of retard- 
ing (perhaps removing) danger in severe maladies ; to mark 
the period when the aid of a physician must, if possible, be 
obtained, and to prevent the incalculable evils, which con- 
tinually occur, in consequence of following the advice of 
ignorant pretenders. 



TILL AFTER TWO MONTHS OLD. 99 

tion be paid to the mode of feeding, may become 
as strong and healthy as if it had been nourished 
with its natural food. 

Those who have the means of providing an ass, 
would do well to give the child three or four meals 
in the day, of the milk of that animal; this should 
be drawn from the udder at the moment it is want- 
ed, and given of the natural heat, which, if the 
weather be very cold, may be retained by putting 
the vessel into which it has been milked, in a basin 
of warm water. The froth should be taken off the 
milk before it is given to the child, but it should 
not be let to stand, as even a quarter of an hour's 
contact with the air, might produce a considerable 
alteration in the quality of the milk. Very thin 
barley, rice, or grit gruel, or panada made of good 
white bread and pure water, should form the in- 
termediate meals, and be varied according to cir- 
cumstances. In some cases, a little weak chicken 
broth may also be given once a day, especially 
if there be much acidity in the stomach. For 
those who cannot be provided with ass's milk, that 
of a cow, with two third parts of warm water, and 
as much white sugar as will give it the sweetness 
of human milk, may be substituted; this should 
be given twice a day at least, fresh from the cow, 
and if it be not very rich, need not have quite so 
much as two thirds water. 

One thing to be particularly observed in bring- 
ing up children in this manner is, that if is always 
better in the beginning to give rather too poor 
than too rich diet; if the food be not sufficiently 



100 TREATMENT OF INFANTS 

nourishing, the infant will show a craving desire 
for more in quantity, and the necessary alter- 
ations may be made accordingly ; but if the food 
should happen to be too rich, it may produce indi- 
gestion, which is particularly dangerous for child- 
ren who are not brought up exactly according to 
the dictates of nature. 

It should be remembered, that every thing 
given to a new-born infant ought to be made as 
sweet as its natural food, and of the same warmth. 

It is very advantageous that children who are 
brought up by hand should suck their food, and 
for this purpose the simplest (and therefore best) 
contrivance, is a bit of sponge or cotton put into 
the neck of a vial bottle, with a sufficient part 
left out of it to bear proportion to the nipple of a 
woman's breast; over this should be tied a piece 
of soft leather, full of small holes, and this 
should be again fastened round the rim of the 
bottle. One great advantage of a glass vessel 
is, that the quantity taken by the child at each 
meal, can be accurately measured, and the food 
can be seen, so that the child may not continue 
to suck when there is no more. Besides, there 
is nothing so easily kept clean, or in which the 
want of cleanliness is so soon discovered; and 
indeed a young child should always* be fed from 
something open or transparent, as great care 
should be taken to prevent it from swallowing 
too fast. The sponge should be taken out of the 
bottle and washed well every time the child has 
sucked, as also the leather covering; and if the 



TILL AFTER TWO MONTHS OLD. 101 

cotton be used, it should be changed every time: 
what remains of the food should be immediately 
thrown away, and the bottle carefully washed. 
There have been many contrivances for making 
children suck artificially, but I know of none 
more safe and convenient than the simple method 
here advised. Vessels not made of transparent 
substances are liable to conceal dirt, and if they 
have long spouts, can hardly fail of being less 
clean than they ought to be. A glass vessel, in the 
form of a small Indian rubber bottle, with a little 
rim round the top, is certainly the best thing 
from which to make an infant suck its food. 

The evacuations of a child who is brought up 
by hand should be particularly observed, and 
alterations made in its food, according to their 
appearances. In general infants require little 
medicine, but their nourishment may be rendered 
medicinal in various ways. If a child who has 
not the breast be costive, grit gruel maybe found 
preferable to barley or rice, and brown sugar 
may be used to sweeten its food instead of white; 
should this not answer the purpose, a little good 
honey may be substituted for sugar, which will 
often be found to succeed. Honey should not 
however be used too frequently, as it is likely to 
cause an acid in the stomach. Broth made of 
very young veal, with a little salt in it, will in 
some cases, remove costivencss; and for children 
who are constitutionally subject to acidities, may 
be preferable to any thing else. At all events 
it may be given for a change, when food of this 
sort is often necessary. 



102 TREATMENT OF INFANTS 

A child brought up by hand, not being in its 
natural state, may possibly have more occasion for 
medicine than one fed from a woman's breast ; 
when the bowels therefore cannot be kept in a 
proper state by varying the food, a little syrup of 
roses or of rhubarb, or a small quantity of mag- 
nesia, must be given now and then, but only when 
absolutely necessary. 

Children, who have not the breast, are apt to 
have much less evacuation from the bladder tban 
those who are suckled; and this is a thing which 
should be particularly guarded against, as it may 
be the means of augmenting a predisposition to 
gravelly complaints, if any such should exist, as 
it frequently does in young infants. For this 
reason, great care should be taken that the food 
of children brought up by hand be sufficiently 
liquid, and if the urine should seem to be in too 
small a quantity, the fennel-water (so often recom- 
mended before) may be frequently given. It is 
not likely tbat a child fed in the manner I have 
directed, will have too small a secretion of urine; 
care must therefore be taken to distinguish be- 
tween that, and the spasmodic retention before 
mentioned, for which the warm bath is a neces- 
sary remedy. 

In many cases, it would be right to give a child 
brought up by hand, a spoonful of the gravy of 
roasted meat every day; not the gravy that is on 
the dish, but that which runs out of the meat 
(sufficiently roasted) when it is cut, and every 
appearance of fat should be taken off, by laying 



TILL AFTER TWO MONTHS OLD. 103 

bits of clean white paper on the top, until no eye 
of grease remain. When a child does not ap- 
pear to thrive, where there is much acid in the 
stomach, or where there may be any suspicion of 
a scrophulous taint in the blood, this is an excel- 
lent remedy, if it be found to agree with the in- 
fant's stomach. 

When a child brought up by hand is subject to 
a looseness, the food should be composed chiefly 
of good white bread (or biscuit) made into pan- 
ada, with either water or milk, and sweetened 
with very white sugar; or of rice gruel with a 
little cinnamon ; or of chicken broth with a bit of 
mace boiled in it; and toast and water with lemon 
peel, &c. &c: grits and barley are better avoided. 
If the looseness be sufficient to be considered as 
a disease, the child must then be treated as di- 
rected for diarrhoea; but what I allude to here, is 
that state of bowels which may be occasioned by 
the food not being exactly suitable to the stomach 
of the infant. 

Another thing of great importance and seldom 
regarded, is to give the child food, during the first 
two months, as often as it ought to suck, if it 
were brought up naturally; and when the food is 
as light and thin as it should be, the child will 
require to have it as often. The custom being 
generally to give thick victuals to infants brought 
up by hand, they do not require to be fed so fre- 
quently; but this is a bad practice, and until the 
child be three or four months old, the nearer the 
food approaches to the liquid state of human milk, 
the better, 



104 TREATMENT OF INFANTS 

When the child is subject to an habitual loose- 
ness, or does not appear to be sufficiently nour- 
ished by its food, there are many things which 
may be tried, such as salop, sago, arrow root, 
&c. ; but all these should be made very thin, and 
given in small quantities at a time. For a healthy 
child, who thrives well, they are unnecessary. 
One thing however, is to be observed here, that 
though chronic diseases do not appear at this early 
age, yet, when there is any suspicion of scroph- 
ula in the blood, it would be right to feed the 
child with nourishment of a more tonic nature 
than is generally necessary; and therefore, some 
portion of animal food might be given from the 
first; beginning with veal broth, and making it 
stronger according as the stomach of the child 
appears able to bear it. Bread is also in this 
case, to be preferred to unfermented grain, and 
with milk and broth, should constitute the chief 
part of the nourishment of those children in whose 
families any thing of scrophula has been observ- 
ed. This malady will be treated of in its proper 
place ; and it is earnestly recommended to moth- 
ers, to pay particular attention to what is said on 
that subject, as perhaps, it is the only disease 
which may be safely and successfully combated 
from the first moment of a child's existence. 
When it is possible to procure a good nurse for 
an infant of this constitution, it is far preferable 
to bringing up by hand; and a robust woman 
who has been accustomed to live rather full, would 
be the best to entrust it to, if her milk on trial 



TILL AFTER TWO MONTHS OLD. 105 

should be found to agree. However, when the 
mother of the child has good health, and her 
blood is free from suspicion of that particular mal- 
ady, she would, undoubtedly, be the best nurse it 
could have; and besides her milk, the child might 
be accustomed to a spoonful of gravy or good 
broth every day, the quantity of which might be 
increased by degrees. 



CHAP. XI. 

HINTS RESPECTING HIRED NURSES. 

As bringing up by hand is not suitable to every 
constitution, there are cases in which a mother 
unable to nurse her child, may be obliged to give 
it to be suckled by a stranger; and it is scarcely 
necessary to say, that the greatest caution should 
be employed in the selection of a proper person 
for that office. All books which profess to treat 
of the management of children, contain ample 
instructions on the manner of choosing a nurse, 
and full descriptions of the various physical and 
moral qualities required: from my own experience, 
I can add nothing to what has been said repeat- 
edly on this subject, and must only refer to those 
who have been accustomed to examine and to 
recommend such persons. 

JVo hired nurse should ever be allowed to have 
any medicinal substance at her command, nor any 



106 TREAT3IENT OF INFANTS 

servant appointed to attend upon her: the former 
to guard against a direct injury to the child's 
health, hy the incautious administration of drugs;* 
and the latter to prevent an indirect one, by giv- 
ing habits of indolence to a person for whom the 
exercise of making her bed, sweeping her room, 
&c. &c. conduces to render her milk more whole- 
some. It is by no means necessary that a woman 
who suckles (especially during the first months, 
when infants pass so many hours in sleep) should 
be perfectly idle, as nurses in great families are 
usually permitted to be; and in fact the lazy, 
gossiping habits which such persons generally 
acquire, arc extremely disadvantageous to them, 
both in a physical and moral point of view. 

It is an unfortunate thing to have a necessity 
for hired nurses, and a difficult matter to treat 
them properly; but when they fulfil their engage- 
ments, and act with fidelity and obedience towards 
those who have been obliged to confide in them, 
their good conduct should be acknowledged and 
recompensed with more generosity than is usual. 
Nurses are often spoiled by absurd indulgence 
during the time of suckling, and thrown off' with 
neglect when it is over: and I have sometimes 
suspected a degree of concealed jealousy, to be 
the true motive of this unjust treatment. 

* Those who arc under the necessity of putting their 
children out to nurse, ought to be very attentive that they 
are not dosed with paregoric and other drugs, for the pur- 
pose of making them sleep. This is very often done by 
ignorant nurses, and is very hurtful to the constitution of 
the child. Am. Ed. 



J 



TILL AFTER TWO MONTHS OLD. 107 

Amongst the many disadvantages attendant on 
the employment of hired nurses, is the great de- 
sire they generally have of making the children 
they suckle excessively fat; for which purpose 
they not only urge them to take as much milk as 
they can possibly swallow, but also, frequently 
resort to means still more hurtful, such as giving 
them malt liquor, and other things capable of 
bloating them into a prodigious size. The over- 
fed children are subject to frequent indigestions, 
and often have their unnatural abundance of flesh 
carried off all at once, by some severe bowel 
complaint, which is ascribed to teething, and 
therefore does not affect the credit of the nurse, 
who boasts " What a fine child she had reared 
until the sickness of his teeth had pulled him down 
so much:" at the same time that it is extremely 
probable, tbc child might not have had any such 
malady, if it had been naturally and moderately 
fed. In all epidemic and contagious diseases, 
those crammed children are in the greatest dan- 
ger; and there is nothing which a mother, who 
is under the necessity of having her child suckled 
by a hired nurse, should check more carefully, 
than the overloading its stomach with milk or any 
other sort of food ; a circumstance of much greater 
importance than others, to which more attention 
is usually paid. 

I have often been induced to think, that many 
of the maladies of children during the time of 
teething, proceed from being suckled by women 
who drink strong liquors; and in more than one 



108 TREATMENT OF INFANTS, &.C. 

instance I have been convinced of the justice of 
this opinion. Those mothers therefore, who have 
the misfortune to be obliged to employ hired nur- 
ses, should pay the greatest attention to this sub- 
ject; and not let any pretence of weakness or 
fatigue, persuade them to allow any spirituous, or 
large quantities of malt liquors, or wine, to be 
taken by the nurse. If a nurse be disturbed in 
the night, and feel herself tired in consequence 
next day, it is much better to get some other per- 
son to attend on the child for two or three hours, 
and to suffer her to repose during that time, than 
to permit her to drink more wine or strong beer 
than usual, by way of acquiring strength. Sleep 
is always likely to increase the quantity, and to 
improve the quality of the milk ; but strong liquors 
can only injure both. 

1 must not omit to mention, that it is very diffi- 
cult to have children weaned gradually, who have 
hired nurses; partly, because it is almost impos- 
sible to prevail on them to suckle at regular times; 
and partly, on account of the prejudices and 
superstitions common to that class from which the 
mother's substitute is usually selected. Children 
therefore, who are not suckled by their mothers, 
are more exposed to that artificial malady attend- 
ant on weaning in the manner generally practised, 
and more likely to want the assistance of medi- 
cine at that time. 



PART THE SECOND. 



MANAGEMENT OF CHILDREN FROM TWO MONTHS 
TO TWO YEARS OLD. 



CHAP. I. 

MANNER OF MAKING CHILDREN HARDY CLOTH- 
ING SHOES EXERCISE. 

When a child is born strong enough to arrive 
at the age of two months, uninjured by any of 
those complaints which have been already men- 
tioned, it may be considered to have escaped a 
considerable part of the dangers which surround 
a human being on first entering the world. If 
the season be mild and the child healthy, it 
should be accustomed by degrees to stay longer 
in the open air, and to have more exercise; and 
should it not begin to cut teeth until the usual 
time, it will have three or four months to thrive 
and grow rohust in, before any natural cause of 
indisposition is likely to occur. This space 
should be occupied in fortifying the constitution; 



110 MANAGEMENT OF CHILDREN 

and, for that purpose, the utmost attention should 
be paid to the child's clothing, sleep, amusement, 
and comfort in every respect. 

The only true way of making children hardy 
(and this may be begun very early) is by letting 
them be a great deal in the open air, covering 
them sufficiently when it is cold, to enable them 
to enjoy it: but they should never be kept out 
longer than appears to give them pleasure; for 
it is impossible that either the air or exercise can 
be of service to an infant who is shivering, shrink- 
ing, and looking bine, in the arms of its attendant; 
and this unfortunately, often happens to those 
whose parents are not sufficiently aware of the 
necessity of warm clothing; and who are not 
very particular respecting tbe persons to whom 
they entrust their children. Tbe servant who 
carries the child, Btops to gossip with some ac- 
quaintance in the cold: perhaps exactly where 
there is a current of wind, and tlie poor babe (if 
no worse consequence result) at least suffers 
during that time, all the painful s< nsations which 
cold occasi as to a delicate frame, and which are 
so likely to augment its weakness. 

It is a very mistaken opinion, which many per- 
sons entertain, that cold air and cold water must 
always be strengthening, as they frequently pro- 
duce exactly the contrary effect. I have long 
been convinced by observation and experience, 
that children, who are brought up according to 
the usual method intended to make them hardy, 
are by no means likely to be the most robust ; 



TILL TWO YEARS OLD. Ill 

and that many a child has been weakened by the 
cold water and the cold air intended to make it 
strong. The instances given to evince the good 
effect of these excesses, are no proofs of their 
advantages, but only show that a child, naturally 
strong enough to resist that sort of treatment, is 
born with a very excellent constitution; for oth- 
erwise, it would probably, have fallen a sacrifice 
(like so many others) before the shrine of preju- 
dice. Mediocrity appears to be the happiest lot 
of man, and whenever, either physically or mor- 
ally, there is any attempt to pass that boundary, 
the balance is lost, and evil exerts its influence. 

I have already said all that is necessary respect- 
ing the first clothing of infants; and though their 
habiliments must be altered as they grow older, 
yet, one general rule should predominate from 
first to last: they should always be light and loose ; 
but warm or cool according to the season, and 
particular feelings and constitution of the child. 
At five or six months old, the clothes should be 
shortened, and shoes put on. The first shoes ought 
to be made of soft woollen cloth, with a thin leather 
sole, to accustom the child to the imprisonment 
of its feet with as little pain as possible. These, 
after a few weeks, maybe exchanged for light leath- 
er; and thus, by degrees, the tender feet may be 
accustomed to thicker and harder covering, by the 
time the child begins to have occasion for a stronger 
protection to them. It is by no means a matter 
of indifference how the shoes of very young child- 
ren are made: if too tight, they occasion corns, 



112 MANAGEMENT OF CHILDREN' 

which I have seen in more than one instance on 
feet under a year old; if too loose, they impede 
the progress of the wearers when they begin to 
walk, and render them liable to fall; but the first 
shoes should rather be too large than too small. 

When it can be contrived to shorten the clothes 
in summer, it will certainly be the best time; but 
as this is not always convenient, if necessary to 
make the change in cold weather, it would be 
better to put on half-boots instead of shoes, that 
the ankles may not suffer from cold. These are 
more suitable than stockings; which, for many 
reasons, would be rather an incumbrance at that 
early age. 

Among the many requisites to be sought after 
in the persons to whom young children are in- 
trusted, one, which though apparently trifling, 
should not be forgotten, is the power of holding 
them equally on the right and on the left arm. It 
is necessary that the child's position should be 
changed when it is carried out, both for its pres- 
ent comfort and to prevent any danger of its grow- 
ing crooked ; and it is also necessary that the ser- 
vant, who carries a heavy child, should be able 
to make use of either arm for this purpose, that 
she may avoid the fatigue which might tempt her 
to sit down with it in cold weather, or to give it 
to a stranger to hold. 

Some physicians, to ensure a great deal of air 
and exercise for children, have recommended the 
use of little carriages; and when these are made 
with very good springs and a soft cushion to sit 



TILL TWO TEARS OLD. 113 

on, and drawn about on gravel walks or smooth 
roads, there is no objection to them; especially 
when a child is eight or nine months old. But if 
made without springs, and used on a rough road, 
the dangerous consequences may be much greater 
than at first appear. A sudden jolt may occasion 
a trifling hurt in one of the hips or adjacent parts, 
of which no one is aware at first, as the infant's 
crying is ascribed to some other of the many 
causes liable to produce that effect; and when at 
length the child begins to walk, is first discovered 
an incurable lameness, or daily increasing deform- 
ity, for which no one can account, and for which 
there is no remedy. There is no place where 
one meets with more deformed people than in 
Dresden: and as the air of that country is whole- 
some, and the Saxons a strong, healthy race, I 
have felt inclined to ascribe this to the common 
custom of putting very young infants into little 
carriages without springs, in which they are drag- 
ged over excessively rough pavement. This mode 
of exercise being extremely accordant with the 
laziness of servants, should be especially attended 
to, and not permitted but in certain cases, and 
with the necessary modifications. I am the more 
particular in mentioning this subject, as I have 
seen these little carriages strongly recommended 
(without any precautions) by some of the best 
medical writers, who probably had not been led. 
by any circumstance, to consider the inconven- 
iences and dangers attendant on the indiscriminate 
use of them. Until a child is six or seven months 
7 



114 MANAGEMENT OF CHILDREN 

old, the safest mode of giving it exercise is to 
have it carried in the arms; or, if in a carriage, 
on the lap of some person who will be careful to 
protect it from violent jolts. We should guard 
against all the possible injuries, from unknown or 
uncertain causes, through which children maybe 
destroyed by acute disease, or rendered miserable 
by chronic maladies, or deformities. 



CHAP. II. 

LEARNING TO WALK BATHING. 

In regard to walking, an accomplishment which 
pique themselves <>n teaching at a very 
early age, it would be far better to prohibit all 
premature instructions, and prevent as much as 
possible all the usual aids. If a healthy child of 
five or six months old, is laid down with its face 
towards the ground*, for a few minutes, three or 
four times every day, it will soon learn to rise up 
on its hands and feet, and move a few steps back- 
wards and forwards; after a short time, it learns 
to go on all-fours (which heavy children will 
sometimes continue for several months;) then 
rises on its feet, by the help of chairs or any other 
support convenient to it, and so walks about for 
some time longer; then tries to stand quite alone; 
and at length discovers its power of moving in this 

* A smooth, dry meadow would probably be the best place. 



TILL TWO YEARS OLD. 115 

manner, from one place to another, without assis- 
tance. Children who learn to walk in this way, 
are firmer on their limbs, less liable to crooked 
legs, and far more secure from falling, than those 
who have been handed about by their attendants: 
however, I must confess, that they do not in 
general walk so soon; for a child permitted to 
learn to walk of itself, will scarcely go alone 
before twelve or thirteen months old. I do not 
consider this as a matter of serious importance, 
though I approve of the practice, and should re- 
commend it to those who can make it convenient: 
when however, the other method is adopted, I 
cannot help urging the expediency of banishing 
from nurseries (except on very extraordinary oc- 
casions) those common aids to the laziness of ser- 
vants, leading-strings and go-carts; things quite 
unnecessary for strong, and often injurious to weak 
children. 

Many people think it right to put children into 
the cold bath as early as at two or three months 
old, and are in such a violent hurry to make them 
strong, that they run the risk of putting an end 
to them entirely. Until children have all their 
teeth, (which is seldom before the end of two 
years,) I am convinced that it would be better to 
defer this practice, unless particular circumstances 
should occasion it to be ordered by a physician. 
In regard to merely washing the skin, a healthy 
child will not require the water warmed in summer; 
at the same time, it is better not to search for the 
very coldest that can be found for this purpose; 



116 MANAGEMENT OF CHILDREN 

and in winter it may be as well always to have it 
a little warmed. The slightest appearance of in- 
disposition should indicate the use of tepid water; 
and on many occasions, (as has been already 
shown, and will be still further hereafter,) an en- 
tire bath of tepid water is not only the simplest, 
but the best remedy that can be used. Sometimes 
a bath of much warmer temperature may be re- 
quired; but, in such cases, it will be ordered by 
a professional man. As a medicine, cold bathing, 
especially in the sea, is frequently necessary; and 
to healthy children, (after the time of dentition is 
over) it is a matter of indifference, and if agreea- 
ble to them, is as good a way of washing the skin 
as any other: hut, as a constant habit, I should 
think it better to be avoided. Why add to the 
necessities of persons in health? 1 shall say no 
more on this subject here, as there will be occa- 
sion to return to it again. 

As soon as children begin to go into the open 
;:ir and to meet strangers, they become more liable 
to epidemic and contagions diseases, as will ai 
to those maladies from which extreme attention 
inav in a great measure preserve them; but there 
is a subject which belongs peculiarly to the period 
of existence which this part of my work is con- 
lined to, and which, as it occasions more or les3 
inconvenience and indisposition to every child, re- 
quires to be treated at full length. The reader 
will easily guess that I mean teething. 



TILL TWO YEARS OLD. 117 



CHAP III. 

TEETH OFTEN IRREGULAR IN THE TIME AND OR- 
DER DIARRHtEA DYSENTERY. 

The time of teething is so very irregular, that 
some children begin to show symptoms of its ap- 
proach so early as the age of two months.* The 
surest mark of teething, at that age, is the great 
quantity of clear water which runs from the 
mouth: heat of the mouth, restlessness, loose- 
ness, &.c. &c. may proceed from other causes; 
but this particular symptom always gives reason 
to expect an early dentition. 

The time of teething is, to many children, a 
season of imminent danger, in which great care 
and some skill might save the lives of many who 
fall victims to the various diseases attendant on 
it. Every slight indisposition during the whole 
time of dentition, should be watched with partic- 
ular attention: it should be observed, whether the 
maladies which appear, are to be ascribed to that, 
or to some other cause; and complaints should 
not be disregarded, because they are supposed 
to be the inevitable consequences of teething. 
Coughs, which arc the effect of having caught 
cold, are often supposed to be occasioned by the 

' Those who have teeth before that age, as well as those 
born with tlicin, are extraordinary instances ; and what are 
tieated of here are only common facts. 



118 MANAGEMENT OF CHILDREN 

teeth, and the proper remedies for a cold neglect- 
ed, until the cough becomes so bad as to occasion 
inflammation of the lungs, which, joined with the 
irritation and fever produced by teething, attain 
such violence as to end fatally. A child's cough 
should never be neglected, but especially during 
the time of dentition; and whether it proceeds 
from a cold or any other cause, some remedy 
should be sought. 

It is a general opinion, that when the teeth are 
cut late, there is more danger than when they 
begin to appear at the usual time, which is about 
the age of seven months. When the cause of this 
delay is eithi r disease or debility, it is natural to 
suppose that teething will bo difficult; but when 
the Late appearance of the teeth is not attended 
with any morbid Bjmptom, that circumstanci alone 
should occasion no alarm. The same opinion 
attach* a to any uncommon appearance in the order 
of cutting the teeth; but a mother need not be 
frightened, though she may perceive irregularities, 
both in the time and the manner of teething. I have 
seen children cuttheir first teeth, at vari< us times. 
between four and twelve months old, with perfect 
safety; and others in great danger, who had but 
just reached the usual period. I have also, several 
times, seen the teeth come out m the most irregu- 
lar manner, (such as one tooth in the under jaw 
and then two or three in the upper, or an upper 
tooth come out first and then the two under, &c.) 
without any great difficulty: but it must be con- 
fessed, that in general, this sort of irregularity is 



TILL TWO YEARS OLD. 119 

attended with more indisposition, than when, at 
the natural time of seven or eight months, the two 
under front teeth appear first, then the two upper, 
and so on, in the order which every woman who 
has had children under her care knows. 

The diarrhoea, so common during the time of 
teething, when it is neither too violent nor of too 
long duration, is not a bad symptom, and often 
prevents fever and convulsions. While it is a 
mere looseness, unattended by pain, fever, or loss 
of appetite, it is rather salutary than otherwise, 
and requires no medicine. A little chicken-broth, 
with a bit of mace or nutmeg boiled in it, may be 
given once or twice a-day, according to the age 
and circumstances of the child; and should it be 
already weaned, rice-water, sweetened with fine 
loaf-sugar, is the best thing it can drink. Should 
there be the least appearance of fever with the 
lax, it will be best to omit the broth, and give 
rice-gruel or panada, instead of it. No astringent 
medicine should be administered without the 
orders of a physician, as the worst consequences 
may result from injudiciously checking a discharge 
from the bowels. Should the diarrhoea be attended 
with fever, a slight emetic of three or four grains 
of ipecacuanha may be given, and afterwards a 
grain of rhubarb every day for a week or a fort- 
night ; to which, in case of the evacuations having 
a sour smell, a few grains of magnesia may be 
joined, until it be removed. 

.Should there appear symptoms of dysentery, 
or blood and mucus in the stools of children, as 



120 MANAGEMENT OF CHILDREN 

sometimes happens during teething, it would be 
expedient to give a tea-spoonful or two of the oil 
of sweet almonds, and a clyster* of rice-water, 
with a little gum arabic dissolved in it. Gum 
arabic may also be dissolved in the child's drink, 
which should be barley or rice-water, sweetened 
with fine white sugar. After the child has been 
sufficiently purged, syrup of poppies may be given 
in the manner directed for other complaints; and 
also a small clvster, composed of about half an 
ounce of tepid water, with >ix or seren drops of 
laudanum, which, if retained in the bowels, will 
not fail to cheek the irritation and forcing. If 
these remedies ere nol found sufficient to cure the 
malady, a physician should be consulted without 

delay, as this i> b stimes a dangerous inflam- 

ma ,;, lv ,1.-;.-. and greal medical knowledge is 
requisite to treat it properly. 

► In ro.rard to clysters, several things are tol bmrnd 

One is the mode of administefing them, in which gre 

Id be taken not to hurt the child; and* 
lll( . liri r ;m( , pipe may perhaps be the safest instrument to 
employ for infants; but with either that or the synn 
D rpe should be directed parallel to the back-bone, and the 
fo£or injected very slowly. Another thing. 
ia that some children have an extreme aversion to taw 
ro „,,dv . and it is very difficult to administer it with any 
.ood effect when they scream and cry. They may be held 
so as to prevent hurting the bowels, but they cannot be 
prevented from shrieking ; so that, unless positively ordered 
by a judicious physician, a clyster should never be given 
to a child by force, as there are but few cases in which this 
is absolutely necessary. 



TILL TWO YEARS OLD. 121 



CHAP. IV. 



VOMITING PAIN BEFORE THE TEETH APPEAR 

HARD SUBSTANCES UNSUITABLE TO THE GUMS 

LANCING THE GUMS BLEEDING BLISTERING. 

Amongst the variety of complaints to which 
children are liable during the period of dentition, 
none is more difficult to cure than the purging 
and vomiting, by which so many are carried off. 
The diarrhoea alone (however difficult it may 
sometimes be to treat it) is of less consequence, 
as there is always aid to be expected from medi- 
cine, and also from food adapted to the circum- 
stances of the case; but the vomiting (which is 
sometimes convulsive) often baffles all attempts 
to check it, as the remedies are immediately 
rejected by the stomach. The application of warm 
flannels to the stomach and bowels, and a warm 
bath (as before-directed) for the feet, should first 
be tried; then an entire bath of tepid water, and 
afterwards volatile liniment with laudanum, (in 
the proportion of a dram of the latter to half an 
ounce of the former,) may be rubbed on the 
stomach. I have known the effervescent saline 
draught produce very good effects; and recollect 
particularly one case in which it succeeded, after 
many other remedies, besides those just men- 
tioned, had been tried in vain. The child was 



122 MANAGEMENT OF CHILDREN 

about fifteen months old, and had been two months 
weaned; the vomiting had been unceasing for two 
days, and was stopped at last by this medicine, 
prepared in the following manner*— a dram of 
carbonate of soda was dissolved in an ounce of 
water, to which was added rather more than half 
an ounce of syrup of white poppies: of this mix- 
ture a very small tea-spoonful,* with half a tea- 
spoonful of fresh lemon-juice, was given during 
the fermentation, which immediately checked the 
vomiting; and in a short time, the child was able 
to retain on its stomach a purgative medicine, 
which was thought necessary: the vomiting re- 
turned once or twice in the course of two or three 
days, and the saline draught continued to produce 
the same effect as at first. 

In a cold climate, or a cold season, one of the 
first remedies to recur to in diarrhoea, dysentery, 
or vomiting, is wanner clothing, both for the feet 
and the body. A piece of flannel over the stom- 
ach and l.ow.]-. and worsted shoes, socks, or half 
stockings, for a child who has never before worn 
any thing of that sort, may sometimes prove more 
efficacious in removing those maladies than any 
internal remedy: and the materials of this addi- 
tional clothing may be thicker or thinner, according 
to the season of the year. One thing necessary 
to be observed in the use of flannel, is to have it 

* Twice this quantity may be given to a child of three 
years old, and four times as much to one of seven, in case 
of severe vomiting. 



TILL TWO YEARS OLD. 123 

perfectly dry; as it attracts the humidity of the 
atmosphere so much, that in situations where linen 
does not become damp, flannel does: indeed, 
when this last is employed for medical purposes, 
it should always be applied warm. 

Slight inflammations of the eijes, during the time 
of teething, are very common, but of little impor- 
tance. I have often observed a red spot on the 
white of the eye, at the side where the tooth was 
coming out, and at first supposed this was the 
effect of cold ; but repeated observation convinced 
me that it was only an attendant on the pain and 
inflammation belonging to the tooth, and required 
no remedy. However, a little tepid milk and 
water, or rose-water, to bathe the eye, can do no 
harm. 

The great pain of the teeth takes place twenty 
or thirty days before they cut through the gums, 
and all that can be done, is to relieve the indispo- 
sitions that they occasion. The nurse of a child 
who shows symptoms of inflammation during the 
time of teething, should live on more cooling diet 
than before; should diminish her quantity of meat 
and wine and beer, and drink a good deal of dilu- 
ting liquors; but one who suckles a child in whom 
symptoms of debility appear at that time, would 
perhaps have occasion for more tonic food, and to 
take bark, or some such medicine; but this last 
is a case much less common than the other, and 
one in which the advice of a physician would be 
necessarj . 

Sometimes rubbing the gums of children gives 



124 MANAGEMENT OF CHILDREN 

them great relief; at other times they cannot bear 
to have them touched. The hard substances 
which are given them to put in their mouths do 
more harm than good: a bit of liquorice-stick or 
of dry iris-root, a small wax candle sewed up in 
linen and dipped in sugar or honey and water, are 
things far preferable to ivory or coral; but per- 
haps, one of the best of all, is a little cake made 
on purpose, of flour and sugar, with a sufficiency 
of egg to make it tough, (not hard,) and formed 
in a convenient shape for the child to put into its 
mouth; and, in case of necessity, there are me- 
dicinal Bubsiancea which can be conveyed by this 
means. 

It has been recommended to lance the gums, as 
a mode of making the teeth come oul more easily : 

bnl some g 1 physicians have disapproved of the 

practice, find I have Been it tried more than once 
without any advantage. When half a tooth is 
out, and a sharp corner of it, still under the gum, 
irritates the child's nerves (as is frequently the 
case,) lancing that part may be of great use: in 
other cases I should rather think it injurious, as I 
have seen troublesome ulcers ensue from the 
wound. However, as some persons of great em- 
inence have approved of this remedy, no doubt 
there are circumstances in which it must be ben- 
eficial; and therefore, if ordered by a respectable 
physician, should be employed with confidence: 
but I should recommend that the operation be 
performed by a skilful practitioner. 

Aphthae in the mouth are not uncommon during 



TILL TWO YEARS OLD. 125 

the time of teething: but this is generally a slight 
malady; and a little honey of roses rubbed on the 
spots, two or three times a-day, will usually be 
found a sufficient remedy: if however, it does not 
answer the purpose, the complaint may be treated 
as has already been directed for the thrush. 

Amongst many other spasmodic sjmptoms to 
which children are liable during the time of den- 
tition, is a retention of urine, for which the warm 
bath is the proper remedy. If the bowels are 
confined, it would be right to give a clyster, (a 
slight infusion of single chamomile flowers would 
be suitable) ; and after that has produced the de- 
sired effect, a tea-spoonful of syrup of poppies on 
going to rest at night. 

An extraordinary quantity of blood going to the 
head, which shows itself by excessive sleepiness, 
redness of the face, and heavy breathing, is one 
of the most dangerous complaints that a child can 
have. For this, it would be necessary to bleed 
immediately; and a leech applied behind each ear 
might answer the purpose: but if it be possible to 
have the advice of a physician instantly, it would 
be better, as bleeding with the lancet might be 
necessary. No delay however, should be made 
in seeking some remedy, as children have died 
during the time of teething with symptoms of 
apoplexy, which the timely application of leeches, 
and the employment of sinapized baths, or fomen- 
tations to the feet, might have prevented. 

Sometimes, blisters behind the ears are very 
beneficial. They serve to draw off the inflam- 



126 MANAGEMENT OF CHILDREN 

mation from the gums, and are also very useful 
for swellings of the glands under the jaws, which 
sometimes occur during the time of dentition; 
especially if a running behind the ears has been 
imprudently checked. 



CHAP. V.* 



ADVANTAGES OF AIR AND EXERCISE BOWELS TO 

BE KEPT OPEN HOW TO TREAT SPAS3IODIC SYMP- 
TOMS ERUPTIONS. 

When children have a great discharge of clear 
water from the mouth, they generally have less 
fever, ami fewer dangerous symptoms in teething. 
Nothing promotes this discharge so much as air 
andexi r is< ; and 1 hare often seen children who, 
while shut up in a room, were uneasy and i 
with the mouth hot and dry, on being carried into 
the open air in a line day, begin to run at the 
mouth abundantly, and immediately grow lively 
and good-humored. 

Great attention should be paid to the state of 
the bowels during teething; and children whose 
constitution it is to have them confined, may pos- 
sibly require some opening medicine from time to 
time. Rhubarb and magnesia, or any of the va- 
rious preparations of rhubarb, are the safest to 
employ for this purpose ; but when there is extra- 
ordinary difficulty in purging a child (or any other 



TILL TWO YEARS OLD. 127 

uncommon symptom,) a physician should be con- 
sulted, who may direct what medicine, and what 
quantity of that medicine, should be administered. 
The bowels of children who are not of a particu- 
larly costive habit, may often be kept in a proper 
state without the assistance of medicine, by 
changes in their food. To such as are already 
weaned, stewed fruit, honey on bread, barley or 
grit gruel, with brown sugar, good mealy potatoes, 
and broths in which apeiient vegetables have been 
boiled, will sometimes have a sufficient effect; 
but if medicine be required, very small quantities 
should be tried at first, for there is nothing more 
injurious than to purge children unnecessarily. 

The slight spasmodic sijmploms, which usually at- 
tend teething, though of no great importance, yet, 
should not be disregarded, as they are only a lesser 
degree of that irritation which sometimes produces 
the most violent convulsions. When children start 
out of their sleep with an appearance of terror, or 
in tears, grind their teeth, or breathe irregularly, 
the cause should be inquired into. If it proceeds 
from indigestion, or any thing wrong in the 
stomach or the bowels, a slight purge will gener- 
ally remove it; but if, after the first passages have 
been cleared, the same symptoms should continue, 
it is evident that they are occasioned by the teeth, 
or some unknown cause, irritating the nerves. As 
a remedy for this, two or three drops of spirit of 
hartshorn may be given in a spoonful of barley 
or rice water, and a tea-spoonful of syrup of white 
poppies, more or less full, according to the child's 
age. 



128 MANAGEMENT OP CHILDREN 

Rashes and eruptions of various kinds are very 
common during the time of teething; but if not 
driven back by cold, or the application of medicinal 
substances, are seldom of any great importance. 
Sometimes the fever throws out a rash which dis- 
appears in a few days without any bad effect, if it 
has not been checked prematurely by any impru- 
dence, or accidental cause: in case however, this 
should have occurred, the immediate use of the 
tepid bath is the best means of recalling it to the 
surface of the skin, and preventing all bad conse- 
quences. 

Eruptions on the head occasioned by teething, re- 
quire only to be washed very clean, and well 
dried: if they are removed by external remedies, 
the children are liable to be carried off by con- 
vulsions or hydrocephalus; whereas, if let alone, 
(hey will go away as soon as the teething is over. 
A very common complaint is a moisture behind 
the ears, which is sometimes accompanied with 
much inflammation, and disfigures children greatly 
for a time. All outward applications should be 
avoided, except such as are necessary to keep the 
parts clean or relieve itching. Milk and water, 
rose-water, or a decoction of marshmallows, or 
of elder-flowers, may be used with safety; but 
nothing of an astringent nature should be em- 
ployed. Sometimes children are affected with 
troublesome and disfiguring eruptions during the 
whole time of dentition; and when they are as- 
certained to proceed from this cause, it requires 
only a little patience to see them removed. It is 



TILL TWO YEARS OLD. 129 

sometimes very easy to drive them from the sur- 
face of the skin; but the injudicious cure of a 
cutaneous malady is very likely to end in convul- 
sions, hydrocephalus, asthma, inflammation of the 
lungs, or acute fever; diseases rather more to be 
feared than any temporary ugliness. In a short 
time all the disfiguring complaints which occur in 
consequence of teething disappear; and no child- 
ren grow up clearer or handsomer than those 
who have had eruptions while cutting their teeth. 
A very slight eruption driven from the surface 
of the skin is capable of producing violent effects. 
I recollect an instance of a child who, after cutting 
his four front teeth without any symptom of in- 
disposition, had a red spot (about the size of half 
a crown) come out on his forehead, which, for 
some time before the appearance of each of the 
next three or four teeth, became inflamed and 
covered with moisture. The child's beauty Avas 
much spoilt by this eruption; and the family phy- 
sician being consulted, ordered an ointment which 
perfectly cured it in a few days: but the next teeth 
were preceded by violent convulsions, which re- 
turned from time to time during the whole period 
of dentition, frequently occasioning serious alarm 
to the medical attendants, and rendering the child 
(who had been a fine strong boy) weak and sickly 
for many years after. Another instance I saw of 
a child, who, a few weeks after a distinct but 
severe small pox, was attacked by an eruption all 
over, of small suppurating pustules, accompanied 
with great uneasiness and itching, which soon 



130 MANAGEMENT OF CHILDREN 

dried off, and were succeeded by fresh ones. The 
person to whom the child's mother applied for 
medical advice, being of opinion that the eruption 
was only a temporary malady attendant on teeth- 
ing, and the child being otherwise in perfect 
health, prevailed on her to make use of no remedy 
either internal or external for a few days, intending 
to order the tepid bath if the complaint continued; 
but at the end of another week the eruption began 
to diminish, and in a few days cleared off perfectly, 
without any medicine. I mention this to show 
that these sort of eruptions do not require so much 
medicine as is generally supposed; but I by 
no means intend to advise that they should be 
neglected: on the contrary, it is always necessary 
rtain the nature of an eruption, particularly 
if it continue long, as there are various contagious 
maladies of this sort, which may be communicated 
to a child, especially by a hired nurse, and which 
should not be allowed to take their course without 
medical assistance. But these would require the 
advice of an experienced physician, both to dis- 
tinguish and to cure. 

In another part of this work, I shall have oc- 
casion to return to the subject of eruptions: what 
I have said here, is sufficient to put mothers on 
their guard respecting the treatment of those which 
are occasioned by dentition. 

Convulsions, I shall also treat of fully in another 
place; for, though a convulsion be a common 
malady during the time of teething, I do not con- 
sider it so much a complaint belonging to that 



i 



TILL TWO YEARS OLD. 131 

period, as an accidental disease, and frequently 
the consequence of mismanagement. A well- 
formed child, who has been taken proper care of 
from its birth, and had sufficient air and exercise, 
will not be liable to convulsions in consequence 
of dentition. 



CHAP. VI. 

WEANING, HOW TO BE EFFECTED WITH EASE 

WHAT FOOD PROPER FOR CHILDREN NECESSA- 
RY CAUTIONS. 

One more subject remains to be mentioned 
here, as particularly belonging to this age, viz. 
weaning; a thing of the greatest importance, 
and by which children in general suffer a great 
deal of unnecessary illness. 

* The time of weaning is of little consequence, 
if the child be in good health; and in cases of 
indisposition, some require to be weaned sooner, 
some later. It has been recommended by phy- 
sicians, that children suspected of a predisposi- 
tion to rickets should not be allowed to suck long ; 
but those who are free from any tendency to this 
malady, and suffer from feverish complaints or 
from coughs during the time of teething, should 

* See Note to p. 34. 



132 MANAGEMENT OF CHILDREN 

{ if possible) have the breast a few months longer 
than would otherwise be requisite. In general, 
from nine months to about a year old, is the pro- 
per tune for weaning: but, except incase of illness 
there is no necessity for being extremely exact 
on this point. When, however, children suffer 
much in teething, great care should be paid to 
.elect an interval of health for the weaning, and 
their diet should be particularly watched until 
the dangers of dentition are quite over. 

I have already mentioned how very advanta- 
geous it is to both mothers and children, to effect 
weaning gradually. Of all the children I have 
ZZ to b be weaned in this manner, I have never 
seen one affected by that indisposition, which 1 
haV e so often heard talked of by old nurses, (and 
even read of in medical books,) under the name 
of the aeamng brash. . , 

When a chUd is weaned at live or s« months 
old the directions given for* bringmg up by 
hand, arc the most applicable to the crcums an- 
ces; bnt, if between the ages of nine and th.r- 
een, the' case is quite different It « ca*«^ 
that children should then know how to cat and 
therefore it is no longer necessary for them to 
Ik their food. The best thing to g.ve them, 
| •„ anv age,) in the commencement of wcan.ng, 
,a Ida! made with good bread and good water 
and white sugar enough to make „ as sweet as 
,1,0 milk they have been used to; and ,f a ch W 
has been subject to wind, a little lemon peel, cm- 

•See Part I. Chap. 10. 



I 



TILL TWO YEARS OLD. 133 

namon, or ginger, may be infused in it: the pan- 
ada should be very smooth, and given at first, 
once, and then twice a day. As soon as the 
child is to have three meals of its new food, one 
should be of bread and weak broth; but the chief 
food of children, till quite weaned, should be 
bread and water. 

When children have entirely left off sucking, 
cow's milk fresh from the udder (not skimmed 
milk) may be given to them, and their food may be 
varied with broth, rice, barley, grits, &c. Eggs 
are good nourishment for children: the yolk may 
be given as soon as they are weaned, and when 
the stomach is accustomed to more solid food, the 
white, which is harder to digest, may also be al- 
lowed. A child just weaned, should, for a week 
or two, be nourished chiefly with liquids. Barley 
or rice water, or milk and water, are the best 
things it can drink between meals, and at night: 
but giving children drink at night would be better 
avoided entirely; but if that be not possible, the 
habit must be broken off gradually and by slow de- 
grees; as also that of drinking between meals, 
which all children require for sometime after 
weaning. 

When children are first weaned, they should 
be fed five or six times a day; but when they 
begin to take solid food, this may be diminished 
to four, and perhaps at last to three times; but 
this, like all other secondary matters, requires 
no positive rule, and must depend on circumstan- 
ces. Bread and milk for breakfast, made in the 



134 MANAGEMENT OF CHILDREN 

beginning, of the consistence of thick cream, but 
mixed with a little hot water, is the best thing to 
give them for the first week: the bread should 
be grated fine, the hot water should be poured on 
it, and then the milk. When milk is given with- 
out water, (which it may in a short time) it should 
be warmed, not boiled, and if it could be had 
warm from the cow, it would be best. A child 
who is just weaned, may have two meals of milk 
in the day, and one of bread and broth; the oth- 
ers may be of gruel, made of either rice, barley, 
or grits; or the yolk of a new-laid egg either raw 
or very little boiled. After some time, the bread 
and milk may be given without the bread being 
grated, the egg may be boiled in the common 
way, the rice, Slc. may be given in substance, 
and many other things may be tried; such as 
good mealy potatoes, oatmeal porridge, stewed 
fruits, puddings, Sec. Tbe effect of every new 
kind of nourishment on the stomach and bowels 
should be carefully watched, and any thing that 
seems to occasion a looseness, or passes through 
undigested, should be prohibited for the present. 
Butter and fat should be positively prohibited 
during the first two years; and the less children 
ever eat of any greasy substance, the better. 
However, as all children are fond of bread and 
butter, I do not suppose it can be injurious to 
them; but the butter should be good and fresh, 
and given in moderation. Buttered toast (in the 
way it is usually made) should never be given to 
children, and indeed till after two years old, it 



TILL TWO YEARS OLD. 135 

would be better to keep butter from them alto- 
gether : after that time it may perhaps be benefi- 
cial, which fat broths and cooked grease never can 
be. Good buttermilk is an excellent drink for 
children ; and so is what is called in Ireland iwo- 
milk whey, when it is well made. 

A variation of diet should take place according 
to the state of a child's bowels, which are not 
always regular, even in perfect health. For ex- 
ample, if a child happen to be costive for a day 
or two, oatmeal or grit-gruel, with brown sugar, 
may be given for breakfast and supper, and mealy 
potatoes with broth at dinner; or a meal of stewed 
prunes, or bread and honey. On the contrary, if 
a child be inclined to a looseness, rice, with very 
fine sugar, boiled in milk, may be given; also the 
yolk of an egg boiled rather hard, bread toasted 
very brown, &c. I mention only a few of the 
substances which may be useful for these two dif- 
ferent tendencies to indisposition; but there are 
many others which may be employed to vary a 
child's food. Sago, arrow-root, Salop, &c. may 
be given to delicate children; but for those who 
are strong and healthy, they are unnecessary, 
and in truth, good bread ought to form the chief 
part of the food of a child under two years old. 
They should not however, be allowed to have a 
piece continually in the hand; but should have it 
at regular times with their meals, while they eat 
four or five times a day, and between breakfast 
and dinner, when that number is reduced to three 
or four times. 



136 MANAGEMENT OF CHILDREN 

It is a great error to give children large quan- 
tities of food by way of strengthening them; and 
still greater, to let them drink wine and strong 
liquors, which should be reserved for medicinal 
purposes. I have never seen more evident marks 
of acquired debility, than in children who were 
crammed with nourishing things, and drank wine 
or beer, several times in the day. Even the 
simplest and wholesomest food, when given in too 
great abundance, may become hurtful; as in the 
instance of a child of two years old, whom I re- 
member to have seen suffering under a high fever, 
occasioned by an indigestion of very good bread. 
This child bad lately recovered from a worm fever, 
andwithher returning health, had acquired that 
increase of appetite so frequent in such cases; 
ber mother having observed this, was very careful 
to have her meals of a moderate quantity, but 
never though! of using any precautions respecting 
stale bread, of which the servant who took care 
of the child, one day suffered her to oat so much, 
that it produced the effect above mentioned. 

Nothing is better for children than cow's milk, 
when it a°grees; but there are constitutions and 
circumstances to which it is unsuitable, and if 
persisted in, may become very injurious. 



TILL TWO YEARS OLD. 137 



CHAP. VII. 

VARIETY OF FOOD PROPER FOR CHILDREN UNDER 
TWO YEARS OLD SUGAR. 

Until a child has completed two years, it is 
better not to give it meat, unless there are sub- 
stantial reasons for doing so. Bread, milk, broth 
and eggs, should form the principal part of the 
nourishment of children, from the time of wean- 
ing till two years old. I know some people have 
a strong prejudice against eggs, (about as well 
founded as that against sugar;) and many will not 
permit their child to eat a new-laid egg boiled or 
poached, who will, nevertheless, feed them on 
puddings, in which eggs (often very stale ones) 
are boiled up with milk and bread, or flour, so as 
to render them far more difficult of digestion than 
in their simple state. It may be that there are 
stomachs with which eggs disagree, and for those, 
it is probable that puddings are also unsuitable; 
but this is seldom the case amongst individuals in 
health: one of the true causes of objecting to give 
eggs to children, is a false notion, which many 
persons entertain, that this sort of food renders 
them liable to break out. I have seen a great 
number fed in the manner I recommend, not one 
of whom has been subject to eruptive complaints., 
which at least proves that eruptions are not the 
inevitable consequences of such diet. 



138 MANAGEMENT OP CHILDREN 

I do not think children ought to be allowed raw 
fruit or watery vegetables, until they begin to eat 
meat; because these are things which they do not 
digest easily, and which, for that reason, are lia- 
ble to occasion weakness of stomach, and to pro- 
duce worms and other maladies. Their food can 
certainly be sufficiently varied with bread, bis- 
cuits, potatoes, eggs, puddings, broth, milk, oat- 
meal and grits, rice, stewed and preserved fruit, 
and jellies of various sorts; to which, if neces- 
sary, may be added sago, salop, arrow-root and 
tapioca. 

Children who may be suspected of a predispo- 
sition to diseases of debility * should have animal 
food sooner than others. They ought to have 
broth ;it a very early age (three or four months 
old) and gravy before they are weaned: it should 
also be tried whether meat will agree with them 
at thirteen or fourteen months old; and if they 
are found to be capable of digesting it perfectly 
(which may easily be discovered by examining 
their evacuations,) a very small quantity should 
be given, at first once a week, then twice a week, 
and so on by slow degrees, until they eat it every 
day. It has put me to pain when I have heard an 
old nurse lament over the pale face of a child 
during the time of dinner, but console herself 
with the reflection that " he would have a fine 
color when he had drank his wine." When wine 
produces this effect it can hardly be beneficial; 

* Scrophula, rickets, &c. 



TILL TWO YEARS OLD. 139 

and indeed, unless ordered by a physician, it 
should never be given to young children. 

The common food of the country they inhabit 
will generally agree with children in health; and 
those who live where it is customary to feed on 
potatoes and milk, oatmeal porridge, polenta, or 
other sorts of farinaceous substances, may safely 
eat of them in moderation; but I have no doubt 
that it is good to vary the food from time to time, 
always, however, watching the effect it produces, 
and having regard to the particular constitution 
of the individual. 

Nothing is so positively wholesome as sugar; 
and there is no liquid which may be more safely 
allowed to children, when it is necessary that they 
should drink out of meal times, than sugar and 
water. If permitted to follow their natural pro- 
pensities, they will frequently prefer it in illness 
to any other diluting liquor; and in this they 
should be indulged, as in many other instinctive 
propensities. Not only children, but adults, when 
their natural tastes are not corrupted by affectation 
or intemperance, are fond of sugar; and there 
have been of late years the most undeniable proofs 
of the salubrity of a substance, which is so of- 
ten prohibited through caprice or mistaken care. 
There is nothing so useful in the weaning of 
children, as it induces them to support the change 
of diet with more patience, and also furnishes 
them with a substance which renders all the food 
it is mixed with, more nourishing and strengthening 
to the stomach. As I shall have occasion to re- 



140 MANAGEMENT OF CHILDREN, &.C. 

turn to this subject in treating of worms, I shall 
say no more on it at present, except to recommend 
mothers to sweeten the food and drink of children 
who are just weaned, as much as they like. 

There does not appear to be any other topic to 
treat of, peculiarly connected with that part of a 
child's existence comprised between the ages of 
two months and two years, and I shall, therefore, 
here conclude the Second Part of this work. 



PART THE THIRD. 



TREATMENT OF CHILDREN AFTER TWO YEARS OLD, 



CHAPTER I. 

DIET REGULAR HOURS OF EATING FRUIT 

EVACUATIONS BED-ROOMS. 

The time of teething being over, there is no 
necessity for any farther division in treating of the 
physical education of children, as there is no 
extraordinary change to mark. The second (or 
rather second part of the first) dentition, although 
it affects some delicate frames with symptoms of 
disease, yet in general, makes so little impression 
on the health, that it cannot be distinguished as 
an important era in existence. 

When the dangers and indispositions attendant 
on cutting the first set of teeth are past, there is 
no longer the same necessity for excessive strict- 
ness with regard to the diet of children in perfect 
health; though it should always be remembered, 
that errors in the quality, or excess in the quan- 



142 TREATMENT OF CHILDREN 

tity of their food, is likely to produce indigestion 
and fever; and these, if often repeated, may lead 
to that debility of stomach which occasions worms 
and other chronic diseases. As they advance in 
years and strength, it is advantageous to leave 
them much at liberty on this subject: the differ- 
ence between children of ten or eleven years old, 
who are allowed to eat of what they please, and 
those of the same age who are under a variety of 
restraints, is very remarkable; the former being 
usually moderate, and the latter almost always 
gluttons. 

Children who are in such a state of health as 
to require a very strict diet, should not be present 
when other persons are eating, unless they are of 
;ni age and character to be convinced of the jus- 
tice and the expediency of the prohibitions impos- 
ed on them. 

As soon as the maladies attendant on teething 
are over, those who have the care of a child 
should endeavour to discover if it has any peculiar- 
ities of constitution; whether any particular sort o! 
food disagrees with its stomach, what is difficull 
of digestion to it, and what is absolutely indigest- 
ible; that which is digested with difficulty, or 
only in part, occasioning uneasiness and more o; 
less fever which passes off in a few hours: tha> 
which is indigestible, and besides these symp- 
toms, produces an inclination to vomit, pains in 
the stomach and bowels, and frequently a diar- 
rhoea, in which the undigested food passes off un- 
altered. One child may be able to digest a sub- 



AFTER TWO YEARS OLD. 143 

stance which would be difficult or impossible to an- 
other ; and it is by no means the softest things which 
are always the easiest of digestion. Cheese and 
hard eggs are generally considered to be indigest- 
ible substances, and yet some children digest 
them as easily as bread: fish is very suitable to 
many stomachs, but difficult of digestion to a 
great number. Honey agrees perfectly with some 
children, whilst to others it is a cause of acidities 
and diarrhoea; many dislike it extremely, and nei- 
ther that, nor any other kind of food should be 
forced on a child against its will: a thing being 
called wholesome, is no reason for obliging a child 
to swallow what is disagreeable. I lay a stress 
on this point, because I have seen children of 
four or five years old, suffer great disgust and 
vexation in being forced to eat spinage, turnips, 
barley, and other such articles of common food, 
without which they might very well have passed 
their whole lives, and which were probably un- 
suitable to their stomachs at that age. 

It is scarcely necessary to say, that regular 
hours for food, exercise, and sleep, are of great 
importance to young and delicate children. The 
times of children's meals should be carefully 
attended to, and adapted to circumstances: some 
require to eat, the moment they awake in the morn- 
ing, whilst others find pleasure in taking exercise 
and air before breakfast; and the wishes of child- 
ren on this subject should always be indulged. 
They should dine at two or three o'clock, and 
have a piece of bread between breakfast and din- 



144 TREATMENT OF CHILDREN" 

ner, if they be hungry. It would be a great ad- 
vantage, if the foreign custom of beginning dinner 
with some sort of* broth or pottage, could be in- 
troduced amongst children in this country, as it 
would prevent them from overloading their stom- 
achs with meat, and would be far preferable to 
(the method employed for this purpose at some 
schools) having a heavy pudding served up first. 
Children should not be urged to drink during 
meals if they do not like it ; many healthy per- 
sons feel no inclination for liquids till they are 
satiated with solid food, and what appears to be a 
natural instinct should not be opposed. Some- 
times children wish for drink immediately on sit- 
ting down to dinner, before they begin to cat; 
and though this is not good as a regular habit, 
yet they should be indulged in moderation; for 
it may be the consequence of having eaten with- 
out drinking some time before, or some other acci- 
dental circumstance may have occasioned thirst. 
It is scarcely necessary to point out the great 
danger resulting from giving children unripe fruit. 
Ripe fruit in moderation will always be benefi- 
cial to children in health, and is of great use in 
many diseases. It is better that children should 
cat fruit with bread than by itself; for it has been 
frequently observed that apples and pears which 

• Barley, oatmeal, grits, or rice, boiled in broth, or mut- 
ton broth with turnips and bread in it, are those which most 
resemble the soups recommended. Broth with one-third 
milk, and the yolk of an egg in it, is very good for children, 
and a thing likely to please the generality of them. 



AFTER TWO YEARS OLD. 145 

have passed through a child undigested when 
eaten alone, have not done so when bread was 
eaten with them. 

Sometimes children have a dislike to meat ; and 
when that is the case, it is the last thing that 
should be forced upon them: indeed, it is not 
improbable that many children would be better 
nourished by eggs, milk, fruit, and farinaceous 
food, than by meat; but all this must depend on 
circumstances. Perhaps we should all be health- 
ier and longer lived, if we had never learnt to 
devour the flesh of animals; but it would be a 
hazardous thing to attempt to bring up the off- 
spring of a creature become carniverous by habit, 
without that sort of nourishment. 

It is of great importance to pay attention to 
the evacuations from the bowels of children in 
health, that any diseased alteration may be imme- 
diately discovered; and it is also necessary to 
observe, that they afford sufficient time to such 
matters. Strong children, when engaged in play, 
(if they be not watched, and prevented from do- 
ing so) will often retain the contents of the bowels 
so long, that the inclination to discharge them 
passes by; and sometimes, an ephemeral fever is 
excited by the overloaded state of the intestines. 
Other inconveniences are also to be dreaded; 
and one of the greatest reasons for guarding 
against, an accumulation of the excrements is, 
that sometimes the effort necessary to clear the 
bowels is so great, that it may possibly occasion 
a rupture. Children should be taught to attempt 
9 



146 TREATMENT OF CHILDREN 

an evacuation at a regular hour, (after their first 
meal in the morning;) and those who have the 
care of them should observe with what effect, that 
they may be reminded (if necessary) at some 
other time in the day, or at least not suffered to 
pass two days without a discharge from the bowels ; 
as this may be remedied by some alteration in 
their diet. The quality of their evacuations, 
should also be examined, and whatever sort of 
food is found to pass through undigested, should 
be prohibited for a time, until some change in the 
state of the stomach, or some augmentation of 
strength from the addition of years, may give 
them the power of digesting it. Any person ac- 
customed to observe the evacuations of a child in 
health, will readily learn to perceive in them the 
appearance of maladies, of which many are to be 
ascertained by this means; such as worms, indi- 
gestion, dysentery, &c. 8cc. The examination 
of the urine is not so necessary in health ; but 
in case of illness it is important, as there are 
many diseases of children in which the alteration, 
and especially the diminution, is a very decisive 
symptom. 

The air that children breathe during the night 
is of the greatest importance; and for this rea- 
son, the rooms in which they sleep, should be 
kept still more clean than those they inhabit by 
day: they should not be crowded with furniture, 
nor should any animals be allowed to inhabit 
them: dogs, cats, and birds, should, therefore, 
be banished from that part of the house; and 



i 



AFTER TWO YEARS OLD. 147 

those who have no other place to keep them in, 
should not have such things at all. 

It is good to accustom children to sleep either 
with or without a light, which can easily be con- 
trived by leaving them in the dark for some hours 
after they go to bed: those who are used always 
to have a candle in the room, are liable to suffer 
very much, when by accident the night-light 
happens to go out. 



CHAP. II. 

PULSE FEVERISHNESS SLIGHT DIARRHOEA 

DOUBLE TEETH IRREGULAR GROWTH. 

No very accurate information is to be obtained 
from the pulses of young children, even in acute 
diseases; and much more is to be learnt by the 
countenance and color, the eyes, the tongue, 
the manner of breathing, and the smell of the 
breath. Any thing extraordinary in the aspect 
of a child, demands immediate attention; and 
the habitual blackness under the eyes, to which 
so many are subject, should not be disregarded, as 
it is a symptom of that debility which occasions 
so many maladies. 

In lively children, the presence of slight fever 
is often imperceptible while they are awake; but 
the quick, heavy breathing in sleep, is a sign of it; 
and when this is observed, the attendant should 



148 TREATMENT OF CHILDREN 

watch the result. Very young children, and all 
those of great nervous sensibility, are extremely 
liable to fever: a slight degree of pain, or the 
least difficulty of digestion, may occasion it; but 
this soon passes off, if they be allowed to repose; 
and if it be not accompanied by pain in the head. 
nor of frequent recurrence, is of no importance. 
When, however, this slight fever is perceived to 
return often, the cause should be ascertained; 
and if not evident to those about the child, a good 
physician should be consulted, lest it might prove 
the commencement of some dangerous chronic 
malady. 

Children arc sometimes very restless, espe- 
cially in hot weather, from a sort of feverishness; 
which, though not absolutely a disease in itself, 
is capable of producing one, by disturbing the re- 
irj t<> health. For this inquietude, 1 
have found tu.i or three grains of purified nitre 
i d in a little water and sugar, at bed time, 
very efficacious; and it is a thing that children 
take willingly. Sometimes the tepid bath is also 
necessary; and 1 have generally found thai using 
it three or four nights in succession, before going 
to rest, was sufficient. A child who requi 
bath, in this way, should have but a very light 
supper at an early hour; and above all things, 
should not be pressed to eat if he shows no ap- 
petite. This slight indisposition appears in child- 
ren under live years old. 

Some children of three or four years old, are 
subject to a slight attack of diarrhoea, in certain 



AFTER TWO YEARS OLD. 149 

changes of weather, or if they have been out in 
wind a little colder than usual: for this three or 
four grains of rhubarb, with a tea-spoonful of syrup 
of white poppies, and a table-spoonful of mint- 
water, given after the child is put to bed, is an 
excellent remedy. If the complaint should be 
such as requires a purgative medicine, this will do 
no injury; and when the looseness is merely oc- 
casioned by the irritation of temporary cold, it 
will generally be found an effectual cure. 

The double teeth which appear between six and 
eight years old, occasion various degrees of in- 
disposition, and sometimes excite symptoms re- 
sembling the commencement of chronic diseases. 
Some children only grow pale and thin for a short 
time, but others become languid, peevish, and 
heavy: and those who are affected in this manner 
require great attention, as it is very possible that 
maladies which have hitherto lain dormant, may 
be developed at this period. According as inflam- 
matory symptoms, or those of debility appear, 
must be the mode of treating them. Some will 
require a cooling diet, and perhaps some mild 
purgatives, whilst others will have occasion for 
infusion of bark or preparations of iron, strength- 
ening food, and warm sea baths. Bathing the 
feet once or twice a week in warm water with 
mustard and vinegar, would be of use in either 
species of indisposition, the head being the part 
chiefly affected; and, whether a child be heated 
or debilitated, whatever draws the blood to the 
extremities will be advantageous. 



150 TREATMENT OF CHILDREN 

The best means of preventing all these indis- 
positions will be, to give children as much air, 
exercise, and amusement as possible; to take 
care that their sleep be not interrupted, that their 
minds be not disturbed, that they have nourishing 
food in moderate quantities, and that they avoid 
every thing which may produce or augment fever. 
When these teeth, four in number, are all cut, 
children who have suffered by them soon recover 
from any appearance of illness. There are many 
children who pass through this period of their lives 
without any sign of interrupted health. • 

The growth of children is often very irregular; 
sometimes proceeding with extraordinary rapidity 
for a few months, and then appearing to stop for 
a similar length of time. The former state is fre- 
quently accompanied with debility; and often 
occasions pains like rheumatism in the limbs: 
there is also, in some instances, a slight irregular 
fever, which requires that great attention should 
be paid, to prevent and remove whatever may pro- 
mote it. The pains only require chafing with a 
warm hand; but great care should be taken that 
a child in this state be not fatigued nor fretted. 
Children are apt to have a great appetite while 
their rapid growth continues, which diminishes 
extremely, as soon as that ceases: neither the 
one nor the other should occasion any uneasiness 
to those about the children, nor do they require 
any particular treatment. 

Children should always have their clothes per- 
fectly well aired; and if (as sometimes happens 



AFTER TWO YEARS OLD. 151 

to those of three or four years old) they shiver at 
putting them on cold, in a winter's morning, they 
should have them a little warmed. It is bad to 
give a painful impression of this sort the first 
thing in the day; and when a child shudders at 
the feel of cold linen, it is either a sign that he is 
not well, or is not yet strong enough to bear it. 
A robust healthy child will feel no unpleasant 
sensation, but rather the contrary, from cold thus 
applied to the skin; and it is far better for a deli- 
cate child to have its clothes made warm before 
they are put on, than to be dressed close to a fire, 
as is so frequently done. Indeed, except in par- 
ticular cases of illness, children should never seek 
warmth by approaching a fire: the natural way 
for them to obtain it, is by running and jumping 
about, and mothers should watch that they are 
never prevented from doing so by gossiping ser- 
vants, who would much rather make them sit by 
the fire. Perhaps I shall be thought to encourage 
tenderness in children too much, when I say that 
those who are very young and delicate ought to 
have their beds a little warmed, in the depth of 
winter; but I am convinced by experience, that 
keeping them warm in their first years, is the way 
to make them hardy afterwards. 



152 TREATMENT OF CHILDREN- 



CHAP. III. 

THE HEADS OF CHILDREN SHOULD BE KEPT COOL 

RUNNING AT THE NOSE NOT TO EE DISREGARDED 

SHORT HAIR BAD HABITS DANGEROUS 

TRICKS DAMP SHOES. 

For many reasons, children should not be put 
to sleep together, nor with old people; each child 
should have a little bed to itself; and this should 
be (generally speaking) without curtains, for the 
purpose of keeping the head cool, a thing of more 
importance than is generally supposed. On this 
account also, their night-caps should be very thin: 
no children are so liable to cold in the head and 
running at the nose, as those who are accustomed 
to have their heads kept warm; and therefore 
perhaps, if they were to leave off night-caps in 
summer, and not put them on (except in case of 
a cold) in winter, it could be no disadvantage. 
However, this, like every thing else of the same 
sort, must depend upon the particular circum- 
stances and constitutions ; but certainly the cooler 
the heads of children can be kept, by day and 
night, the better. They should not, however, go 
out bareheaded, as both the heat of summer and 
the cold of winter are very likely to occasion run- 
ning at the nose ; which, however, straw hats or 
the lightest beaver, are sufficient to prevent. 

A running at the nose should not be neglected 



AFTER TWO YEARS OLD. 153 

until it becomes habitual; as, besides being very 
troublesome and disfiguring to a child, it may at 
length lead to very disagreeable maladies in the 
nose, from the continual augmented secretion in 
that organ. Bathing the feet is one of the best 
remedies for a recent cold in the head, # and will 
often remove the complaint in a day or two; but 
if it continue for any length of time, a good phy- 
sician or a surgeon should be consulted, who may 
be able to know whether this be a natural defect 
or an acquired infirmity ; which it is of importance 
to distinguish, the latter increasing, and the for- 
mer generally diminishing, as the child advances 
in years and strength. 

The hair of children should be short till after 
eight or nine years old; as the cooler the head 
can be kept, the less danger there is of many 
maladies belonging to that part, especially water 
on the brain. When the production of the four 
double teeth, above mentioned, is attended with 
much inflammation, (as sometimes happens,) it is 
not improbable that this may occasion the devel- 
opement of that fatal disease; and whatever di- 
minishes the heat of the head is likely to be ad- 
vantageous. Besides, there is reason to suppose 
that children who have a great quantity of hair, 
are those most liable to eruptions on the head, 
and certainly in them, these eruptions are the most 
difficult to cure. The trouble, also, required 
for keeping long hair sufficiently clean, and the 

* Persons who live on the sea shore will find the sea water 
very useful for this purpose. 



154 TREATMENT OF CHILDREN 

length of time necessary for this purpose, is often 
a cause of much ill-humor, and many cross 
words, which would be better avoided, between 
children and their attendants. 

Mothers, whose vanity may be alarmed, lest 
constantly cutting the hair for so many years, 
should make that of their daughters coarse, may 
be assured that they have no cause for this ap- 
prehension, if the hair be constantly brushed: I 
have never seen softer, finer hair, than on girls 
who have had it short (like that of school-boys,) 
until they were in their tenth year. In another 
part of this work, I have already expressed a dis- 
approbation of fine combs,* which should never 
be used except on some extraordinary occasion. 
When there is any inclination to break out in the 
head, fine combs are very likely to promote it; 
and there is no doubt, that the heads of children, 
which are never touched by them, are much 
cleaner than those which are scratched and scrap- 
ed every day. If any dirt appear on a child's 
head, which a brush will not take away, that par- 
ticular part should be rubbed with a towel and 
soap and water; but in general, the brush will be 
found quite sufficient to keep it perfectly clean. 
The more the head is combed, the more it will 
require to be combed; as any one will find who 
tries the experiment. However, it must be allow- 
ed that there may be exceptions to this, as to 
every other rule. 

Children easily acquire bad habits; many of 
* Sometimes called small-tooth combs. 



AFTER TWO YEARS OLD. 155 

them of little importance, but disagreeable in 
appearance, and difficult to overcome. A tempo- 
rary weakness of the eyes, or the itching occa- 
sioned by a trifling abscess on the eye-lid, (to 
which some children are subject,) frequently gives 
rise to continual winking; and if a child who has 
acquired this habit be not watched, and induced 
to correct it speedily, it may soon become an in- 
curable defect.* Squinting, when not occasioned 
by hydrocephalus, can scarcely be acquired by a 
child who has tolerably observing attendants. 
Looking into a broken or bad looking-glass, or 
through ill glazed windows, or any thing else 
which causes a distortion of the eyes, if frequently 
repeated, may produce this deformity; but these 
are things which must be evident to the persons 
about children, (if they are not unpardonably 
careless,) and should be immediately remedied. 

Amongst many silly tricks played with children, 
is that of lifting them up by the head, so as to 
hang all the weight of the body on the neck; a 
thing, which certainly no one aware of the ex- 
cessive danger, would ever practise. It is one 
of those follies which may lead to instant death, 
and can never produce any sort of pleasure or 
advantage; though there have been mothers ab- 
surd enough to suppose that it would add to the 
beauty of their daughters by lengthening their 
necks. Children should be early instructed of the 

* It is sometimes caused by shedding or changing of the 
eyelid. Am. Ed. 



156 TREATMENT OF CHILDREN 

peril of this trick, and desired never to suffer any 
one to lift them up by the head. Tickling child- 
ren is another foolish practice, attended with 
danger; which they should be cautioned not to 
allow, and not to practise upon one another.' 

All children, but particularly females, or those 
who are very delicate, should be taught to change 
their shoes whenever they have got wet ; and, as 
far as it is possible, to guard against the feet get- 
ting wet at all, by having strong walking shoes. 
However, while in exercise, it is of compara- 
tively small importance ; but sitting still, with the 
feet artificially cold from wet shoes and stockings, 
is hurtful to most people, and likely to occasion 
head-aches, sore-throats, coughs, colics, kc. The 
continued application of cold to the lower extre- 
mities, is particularly unwholesome for those who 
are subject to have too much blood in the head ; 
an«l. as thia i~ frequently die case with children, 
ii i- evident how very bad it must be for them to 
keep on wet shoes and stockings when they are 
not in exercise. I lay a particular stress on this 
subject, as an author of high reputation has re- 
commended that the shoes of children be made 
so as to let in water, by way of rendering them 
hardy : had he advised that they should go with- 
out any, he might have been right ; for if shoes 
and stockings were never used, we should pro- 
bably suffer no more from cold in the feet than 
in the face ; and, in fact, I have frequently cured 

* Pressing the hands on the eyes in sport, has sometimes 
destroyed vision. Am. Ed. 



AFTER TWO YEARS OLD. 157 

maladies of peasants' children, in places where 
they are not accustomed to wear shoes, without 
any precautions respecting the feet, though I 
should (in similar cases) have advised worsted 
socks or stockings, for those who had ever been 
used to cover them. But persons who have had 
early habits of clothing the feet, often find that 
these are the parts most susceptible of cold ; and 
this occurs even amongst adults of strong consti- 
tutions. 

The way to make children robust, is to guard 
them against the attacks of disease ; and this is 
not to be done by braving dangers, but by shun- 
ning them. Healthy children should not, how- 
ever, be kept in the house for fear of a shower 
of rain : if they get wet, there is little danger of 
their catching cold when they have well-aired 
clothes to change immediately ; but if they must 
wait shivering in their wet things, while clean 
ones are to be dried, even the strongest will be 
liable to dangerous maladies ; the best method 
to avoid which, would be to strip the children, 
and put them into bed till dry clothes could be 
got ready. 



158 TREATMENT OF CHILDREN 



CHAP. IV. 

CLEANLINESS COLD BATHING COLD DRINK 

SLIGHT INDISPOSITIONS PRECAUTIONS. 

Children who are well taken care of, will ac- 
quire habits of cleanliness before they are aware 
of their advantages; and those about them, should 
as they advance in age, impress them with the 
necessity of continuing those habits without the 
assistance of others. They should be taught to 
wash themselves as soon as they can do it con- 
veniently ; and they will be less inclined to be- 
come dirty through laziness, than if accustomed 
too long to depend on the aid of servants : 
besides, that which children do for themselves, 
being done more to their satisfaction than what 
others do for them, they will be less inclined to 
dislike and neglect. 

Cold bathing during the summer months, (that 
is to say in a river, lake, or the open sea,) is very 
agreeable, and of the greatest benefit to many 
children ; but not to all : and it should be par- 
ticularly observed whether it agrees, as children 
for whom it is not suitable, have sometimes no 
dislike to the water, but find pleasure in doing 
the same as their companions. But I have known 
more than one instance of severe maladies, occa- 
sioned by persisting in the use of the cold bath 
when it did not agree : it is evident that the wa- 
ter is unfit for a child who looks pale on coming 



AFTER TWO YEARS OLD. 159 

out of it, and is sleepy and tired afterwards.* 
When this is observed, the bathing should be 
immediately discontinued, as it can only produce 
bad effects; however it is to be observed that 
some individuals are affected in this way by sea- 
bathing, who feel no inconvenience from fresh 
water ; and, on the contrary, others, who suffer 
from fresh-water bathing, find the sea of the 
greatest advantage. When the cold bath entirely 
agrees, there is a glow over the face and the 
whole body on coming out of the water, and the 
child appears more lively and animated than 
usual. With regard to putting children into the 
water by force, it is more likely to injure than 
benefit : however, there may be extraordinary 
cases, in Avhich this, like other desperate reme- 
dies, must be tried ; and therefore, if prescribed 
by a really good physician, his orders should be 
obeyed. Baths, either cold or hot, should be 
used before meals, and children should always be 
dried after them. 

It would be right to teach children as early as 
possible, that it is dangerous to drink any thing 
cold when they are heated by exercise : it is by 
no means difficult to impress them with a sense 
of this peril; and particularly necessary to do so, 
as they are naturally inclined to like cold fluid, 
and ought to be habituated to it, from the time 
they leave off drinking at night, and between 

* Children should not ho allowed, as is often done, to re- 
main too long in the bath, as this is very weakening. 
Am. Ed. 



160 TREATMENT OP CHILDREN 

meals after weaning. And here I must enforce, 

(that nothing is more unwholesome for delicate 
children, than to drink warm diluting liquors, 
when not suffering under some malady for which 
these are necessary. A warm beverage relaxes 
the stomach, increases perspiration, and promotes 
debility, and is therefore required in acute dis- 
eases, when we must weaken in order to cure. 
Except in such cases, children should have as 
little as possible of warm liquors ; I do not mean 
to say that, in cold climates or cold seasons, they 
should not have their milk or gruel (or whatever 
else mav be given to them) for breakfast, warm, 
as those things, being eaten with bread, partake 
more of the nature of solid, than liquid food; but 
if, for instance, a cbild is thirsty, after a plentiful 
meal of hot milk and bread, or potatoes or por- 
ridge, a glass of good cold water is much whole- 
somer than hot tea, or indeed any thing else. 

The slightest appearance of indisposition in a 
child <>t' any age should excite the watchfulness 
of the attendants, even though there may be no 
occasion for administering medicines. Maladies 
may also be often checked, by timely remedies 
of the simplest sort. Head-ache, with foul tongue, 
usuallv requires a purgative; inclination to vomit, 
an emetic: but when there is merely great heat 
of the skin, a high quick pulse, and excessive 
thirst, bed, quietness and warm drink, will fre- 
quently be found sufficient. 

If a healthy child be suddenly attacked with 
vomiting and purging, it is clear that there is 



AFTER TWO YEARS OLD. 161 

something which ought to be carried off, and such 
remedies should be employed as promote this 
object. Warm water will often be found suffi- 
cient, (for little children, sugar should be added,) 
and a few grains of ipecacuanha may also be 
given, if thought necessary. For purging, it 
will always be found safe to give weak chicken- 
broth, rice-water, or some other diluting liquor, 
in abundance, and perhaps a slight infusion of 
rhubarb; and in all indispositions of this sort, a 
low diet will be the best. Meat, and every thing 
heating or difficult of digestion, should be pro- 
hibited. If the complaint should take a decided 
form, the proper directions for treating it will be 
found in the chapter on diarrhoea, &c. ; and in 
case any violent or strange symptoms should ap- 
pear, a physician should be immediately called, 
lest the malady might be occasioned by some 
poisonous substance, which would require a par- 
ticular mode of treatment. 

When any extraordinary symptoms appear in a 
child whose general health is good, they need not 
terrify the parents, though they should be attended 
to, and the causes (if possible) discovered and 
removed; but a solitary and accidental sign of 
illness is not to be considered as a proof of dis- 
ease. The caprices of nature are numerous, and 
often occasion unnecessary fears. 

A small quantity of blood appearing accident- 
ally and without pain, sickness, or diarrhoea, in 
the evacuations from the bowels of a strong child, 
need not be a subject of alarm: it is a sign of 
10 



162 TREATMENT OF CHILDREN 

being overheated; and the same cause, especially 
by too much exercise, has somstimes occasioned 
a little blood to be mixed in the urine, giving it a 
blackish color and sediment, which has a frightful 
appearance. Repose, a cooling diet, and nitre, 
are the proper remedies in both cases. These 
symptoms are of no importance in a strong child, 
who has no other mark of indisposition, if not of 
frequent recurrence; but as they are not very 
common, (especially the black urine,) it is neces- 
sary to consult a medical man, if they return fre- 
quently. 

A child who wakens with a hoarse cough and 
sore throat, in cold weather, may be saved from 
a bad illness, by remaining in bed till after break- 
fast. The child should Qot, however, be obliged 
to lie down all that time, but should have the body 
and anus well covered with some convenient 
clothing, and be allowed to sit up and occupy it- 
self with toys or books, according to the age and 
circumstances. After eating, the skin is less 
susceptible of cold, and besides, the rooms will 
have had time to get warm. When this has been 
found necessary in the morning, it is prudent to 
bathe the feet at night with warm water and salt, 
and give some warm liquid as advised for colds.* 
In bathing the feet for a recent cold, or any slight 
indisposition, it is always better to mix salt in the 
water; and persons who live on the sea-shore may 
use sea-water, for this purpose. 

■ See Chapter VII. of the Fourth Part. 



i 



AFTER TWO YEARS OLD. 163 

In cases of severe illness, when, either on ac- 
count of violent pain in the head, or great weak- 
ness, it is very troublesome to a child to be raised 
for the purpose of having the feet bathed, a person 
who is not very awkward, may easily place a deep 
wash-hand basin under the bed-clothes; and by 
making the patient lie on the back, and raise the 
knees, (which is not usually a disagreeable pos- 
ture to a sick child) the bath may be used with 
good effect. I have often seen this method tried 
with success. Some one should hold the basin, 
and (for fear of accidents) there should be laid 
under it a large well-aired cloth, folded several 
times, which may serve to dry the feet afterwards ; 
there should also be something put over the child's 
knees, to prevent the vapor of the warm water 
from damping the bed-coverings. It is scarcely 
necessary to say that this would not answer for a 
very unruly child, or one in a violent delirium. 

In case of leeches being applied to the breast 
of a child, (as is often necessary for asthma, 
inflammation of the lungs, &c.) it is of great 
importance to guard against taking cold, by expos- 
ing the part to the air for any length of time; to 
avoid this danger, a piece of flannel (which may 
have strings to fasten behind) should be laid over 
the breast, after having as many holes made in it, 
as there arc leeches to apply. 

When a child shows symptoms of indisposition 
without apparent cause, it is always prudent to 
inquire what malady is in the neighborhood, lest 
they should prove the forerunners of any conta* 



164 TREATMENT OF CHILDREN 

gious or epidemic disease, which might be ren- 
dered less pernicious by particular attention; and 
this is one of the advantages of having a family 
physician, especially in a great city. 

If a child in any illness evince a disgust to swept 
drink, and express a wish for sour things, it ia B 
sign the malady is bilious; and the instinct which 
points out acidulated drink should be indulged. 
A patient in this state, who requires food, will 
probably find what is called in Tuscany a cardial. 
very palatable; this is made by mixing the yolk 
of an egg in a large cup of broth, and then adding 
;i tea-spoonful of lemon juice, which may be 
poured on a piece of toasted bread. 

The hiccough is an accidental inconvenience, 
rather than malady, to which all children are 
liable; and it is a common practice to startle 
or frighten, by way of curing it: this would be 
better avoided, and a little cold water or bit of 
pugar will frequently answer the purpose of cheek* 
ing it; or, if these are not found surlicicnt, a few 
drops of lemon-juice or vinegar will seldom fail. 
When, however, acids do not remove it and it 
returns frequently, a physician should be consult- 
ed; as there might be something wrong in the 
stomach, which would require the aid of medi- 
cine to remove. Of course, it will be understood 
that I do not mean to speak of the convulsive 
symptom that appears in dangerous maladies; but 
the common hiccough, to which old and young 
persons are liable when in health. 

If a child complains of acute pain in any part, 



AFTER TWO YEARS OLD. 165 

of which the cause is doubtful or unknown, the 
advice of a physician is probably necessary, and 
should be sought without delay; as the continu- 
ance of suffering might produce dangerous dis- 
eases, which the timely employment of proper 
remedies could prevent. 

Persons in restricted circumstances, are often 
deterred from calling a professional man by econo- 
mical motives, reflecting that if an illness be of 
long duration, the expense may become consid- 
erable : but this is a great error ; for in many cases, 
if medical assistance be obtained on the first day 
of a malady, it may be extremely shortened, so 
as to give occasion for much fewer visits from the 
doctor, than if he is not called until it has lasted 
some days. 



CHAP. V. 

CHOPPED LIPS CHILBLAINS SLIGHT BURNS 

BRUISES WOUNDS. 

Children who are allowed to be as much in 
the open air as they ought, though they may find 
no other disadvantage from cold, yet are liable, 
in frosty and windy weather, to suffer from chop- 
ped lips, roughness of skin, and chilblains ; but, 
with proper precautions, these trilling inconven- 
iences (for they seldom amount to any thing 



166 TREATMENT OF CHILDREN 

more,) may be entirely avoided or greatly dimin- 
ished'. The first and chief care should be, to 
keep the children at a distance from fires, espe- 
cially when they are just come out of the cold air, 
and are likely to return into it immediately, the 
next is, to keep up the circulation by rubbing the 
skin sufficiently; and the third, to be very atten- 
tive in having it quickly and perfectly dried after 
washing. 

The best way of preventing that very disagree- 
able swelling and cracking of the lips to which 
some children (as well as adults) are subject, is to 
wash them the first thing in the morning with very 
cold water and a coarse towel, and to rub them 
hard in drying. Children should be taught as 
soon as possible to do this for themselves, as they 
will bear harder rubbing from their own hands 
than from others; and if not counteracted by ap- 
proaching the fire, this will be found a sure me- 
thod of avoiding the above mentioned inconven- 
ience. For those who are liable to have the 
skin of the face become rough in cold windy 
weather, it is better, during the winter season, 
to wash it only on going to bed at night, with 
warm water in which some bran has been boiled, 
and to refrain from wetting any part in the morn- 
ing, except the eyes, lips, and ears, which should 
always be washed with cold water. 

It is easier to prevent, than to cure chilblains : 
those children who are accustomed to warm them- 
selves by the fire in frosty weather, will rarely 
escape them ; but suffering the extremities to 



AFTER TWO TEARS OLD. 167 

continue long cold, is almost as likely to occasion 
this troublesome complaint. Children should be 
taught to warm themselves by jumping about and 
clapping their hands; and when they are too 
young to do this, their feet and hands should be 
rubbed for them, and shoes and gloves, well 
warmed, be put on, to preserve the heat excited 
by friction. 

When there is any reason to expect a child to 
have chilblains, worsted socks or stockings should 
be put on at the first appearance of autumnal 
frost, and gloves of the same, with leather over 
them. The feet and hands should be rubbed night 
and morning, with either camphorated spirits, 
brandy, vinegar, or brine ; and at night, when 
the child goes to bed, the feet should be wrapped 
up in a piece of hot flannel. 

Chilblains on the feet require the greatest at- 
tention, as they often prevent children from tak- 
ing exercise, or at least render them unwilling to 
move; which should be obviated as much as pos- 
sible (if the malady cannot be entirely prevent- 
ed,) by shoes of soft leather, lined with flannol 
or fur, and made in such a manner as not to press 
upon the swelling. 

I have seen the smoke of burnt bran employed 
with the greatest advantage for children; and I 
recommend it with the more confidence, because 
I first learnt the use of it from an excellent phy- 
sician. A little dry bran is thrown on a chafing- 
dish of live coals, over which the hands or feet 
must be held, sufficiently near to receive the 



168 TREATMENT OF CHILDREN 

thick smoke: a few minutes suffice for this ope- 
ration, which relieves the itching and diminishes 
the swelling. It should be frequently repeated 
in the day; and by employing it just before the 
child goes to bed, the effects will be more perma- 
nent. 

If chilblains are so bad as to break, they must 
at first be dressed with emollient ointment, like 
other sores; and for this purpose, the common 
spermaceti ointment is as good as any thing else: 
afterwards, that is to say, when the inflammation 
is diminished, they should be covered with lint 
dipped in the vegcto-mineral water; and loose 
gloves should be worn constantly, partly to keep 
the air from the wound, and partly on account of 
the poisonous quality of this remedy. 

If, notwithstanding every precaution and atten- 
tion, chilblains should come to a great height, it 
is necessary to consult a medical professor, lest 
they may happen to be combined with some other 
disease which requires internal remedies. 

When children begin to run alone, and to en- 
joy that degree of liberty which is necessary for 
their moral and physical welfare, they become 
liable to many accidents, for which the persons 
about them should be prepared ; and though con- 
stant attention and much care will generally pre- 
vent great hurts, yet small ones are scarcely to 
be avoided. Slight burns and bruises, which 
might become serious complaints if neglected, are 
frequently cured easily, by simple, but immediate 
remedies; and the former especially, if quickly 



AFTER TWO YEARS OLD. 169 

attended to, may be prevented from becoming 
troublesome sores. 

For slight burns, the immediate application of 
spirits, ink, vinegar, forge water, or very cold 
spring water, will be useful; and I have many 
times seen large burns, when the skin was not 
broken, perfectly cured in a very short time by a 
cataplasm of soap and brandy. The soap should 
be scraped fine, and laid very thick on a piece 
of linen; the brandy poured on it, and then ap- 
plied to the burn; which should be covered with 
linen dipped in brandy, while the soap is prepar- 
ing: all this should be done very quickly; other- 
wise the remedy will be of no use. The cata- 
plasm should not be removed for five or six hours, 
and should be kept constantly wet with brandy 
during that time. If this remedy is instantly em- 
ployed, it will prevent any blister from rising. 

A burn, when any part of the skin has been 
broken, must be treated quite differently; and 
the simplest and readiest application is ceruse* 
mixed with salad oil, to the consistence of an 
ointment, by which I have repeatedly seen su- 
perficial burns cured without the assistance of 
any other remedy. The materials for this oint- 

" It must bo observed that ceruse is a most poisonous 
substance, and therefore should not be left in the way of 
children ; as curiosity might tempt them to tasf.e the pow- 
der, and its sweetness induce them to swallow it. For the 
same reason, in case of burns on the fingers, they should 
be carefully covered, to prevent all possibility of putting in 
the mouth. 



170 TREATMENT OF CHILDREN 

merit should always be at hand, and prepared as 
quickly as possible : in the mean time the wound 
must be protected from the air by laying some- 
thing hollow (a bowl or saucer) over the part, so 
as not to let any thing touch the hurt, and then 
covering it with a cloth. The ointment should 
be spread on strips of linen, and laid on the 
wound, so as to cover it perfectly; and then it 
should be bandaged over. The bits of linen, 
covered with ointment, may be changed once or 
twice a day; oftener, if the part feel hot and un- 
easy; and the ceruse which sticks to the skin 
should not be rubbed off till the wound is quite 
healed. This will generally prevent the suppu- 
ration of a slight burn; but if such should take 
place, the wound may be dressed with sperma- 
ceti ointment. These remedies are proposed as 
the most convenient to have recourse to without 
delay: there are many others equally efficacious; 
but I do not wish to load this work with more 
prescriptions than are absolutely necessary. 

The foregoing advice refers only to slight, su- 
perficial burns: when more severe burns have 
taken place, medical assistance must be sought 
as quickly as possible; and, in the mean time, 
the best thing that can be done is to keep the 
part that has been burnt in cold water till the ar- 
rival of the physician.* 

Superficial burns may extend over so large a 



* Instead of this mode, I would recommend the applica- 
tion of linen rags saturated with lamp oil. Am. Ed. 



AFTER TWO TEARS OLD. 171 

portion of the skin as to occasion fever; which 
must be treated, like other indispositions of that 
nature, with confinement to bed and diluting 
liquors; also silence, darkness, &c, according 
to the intensity of it: but when a burn is severe 
enough to produce this effect, a professional man 
should be immediately consulted, as the compli- 
cation of fever might totally alter the simple na- 
ture of the wound, and render a different method 
of treating it necessary. 

It is right to observe, that when a burn has 
once occasioned a blister, especially on the lower 
extremities, it cannot be expected to heal ra- 
pidly, but will take three weeks before it is cur- 
ed. For burns (or any other sort of wounds) on 
the legs or feet, it is necessary to keep the limb 
as much as possible in repose, and on a level 
with the body; so that a child who has had a 
hurt of this nature, ought to lie on a bed or sofa 
great part of the day, at least during the first 
week. 

For slight contusions, when the skin is not 
broken, camphorated spirit, opodeldoc, vinegar, 
or salt and water, are very good applications; 
but if there is a scratch as well as a bruise, nitre 
and water, or the vegeto-mineral water, would 
be better, as they do not smart so much.* For 
those bruises to which children are so liable 
about the forehead and eyebrows, and which 

* To prevent discoloration, rub the bruised part with 
butter, when the skin is not broken. Am. Ed. 



172 TREATMENT OF CHILDREN 

sometimes look so frightful, there is nothing bet- 
ter than to fold a piece of soft linen so many 
times as to make it about a quarter of an inch 
thick, and proportioned to the size of the bruise: 
this should be dipped in very cold water, laid on 
the part which is beginning to swell, and ban- 
daged so as to press on it firmly, without, how- 
ever, making the child very uneasy: it should be 
kept on for several hours, and must be unban- 
daged now and then to dip the folded linen in 
cold water; but should be immediately put on 
again, as the cold and the pressure are equally 
efficacious. 

If a child has had a blow on the head without 
vomiting after it, this is a proof that no important 
injury has been suffered ; but even when the 
stomach is affected by a hurt of this sort, it is no 
positive reason for being very much alarmed, 
though it is a proof that the blow has been 
severe. It would always, however, be prudent 
to use the sinapized bath for the feet of a child 
who had received a hurt in the head, and also to 
lower the diet for a few days. These precautions, 
employed without necessity, can do no harm; 
whereas the neglect of them, when they ought to 
be used, may be the cause of serious injury. It 
is almost unnecessary to say, that in any case 
which requires surgical assistance, the least delay 
is dangerous; and especially in regard to hurts 
on the head, for which immediate bleeding may 
be of the utmost importance. 

In many countries it is the custom for children, 



AFTER TWO YEARS OLD. 173 

till two or three years old, to wear leather caps, 
stuffed cushions, and guards of various sorts, 
round the forehead, to prevent the danger of that 
kind of blows above alluded to: but I believe 
them to be very bad things, on account of the 
unnatural degree of heat they must excite in that 
part; and would rather advise to run the risk of 
the possible mischief consequent to a fall, than 
that likely to result from keeping the head too 
warm. 

With regard to scratches or slight wounds of 
the skin, the object should be to protect them 
from the impression of air and cold; and, for this 
purpose, I have seen employed, with the greatest 
advantage, (by order of one of the first surgeons 
in Europe,) the skin which adheres to the shell 
of a raw egg, which should be put on without 
drying it: this sticks fast to the part wounded, 
and should be suffered to remain until it comes 
off of itself. If this should happen before the 
part be healed, the egg-skin should be renewed; 
and in case a suppuration takes place under it, a 
hole should be cut in the egg-skin, at the lower 
edge of the wound, and the matter pressed out; 
but it should not be taken off. As there is gen- 
erally a contusion with these sort of wounds, 
some folds of linen, dipped in vegeto-mineral wa- 
ter, should be laid over the part that is bruised, 
and kepi wet while any inflammation appears. 
It is almost needless to say that the egg ought to 
be fresh. 

A slight cut with any sharp instrument should 



174 TREATMENT OF CHILDREN 

have the edges brought close together, and a bit 
of diachylon, or common black plaster, laid over 
to keep them so. A wound which has been made 
in such a manner as to give reason to fear gravel 
or sand might have got into it, should be first 
washed with warm wine and water, and then cov- 
ered with any one of the above-mentioned sub- 
stances, to protect it from the air. Nature re- 
quires but little assistance in the cure of slight 
wounds; but when there is any considerable 
hurt, it is much better at once to consult a pro- 
fessional man. 

Mothers should be very cautious how they 
blame servants who have the care of children for 
the trilling accidents which may happen to them, 
lest it might lead to dangerous consequences, by 
inducing them to conceal falls and hurts, of which 
the bad effects might have been prevented by im- 
mediately relating all the circumstances with 
truth and accuracy to a good surgeon. No one 
who undertakes the care of a child would be so 
cruel and silly as to injure it intentionally, but an 
accident may happen to the most careful person; 
and any one who is found too careless to be re- 
lied on for the common degree of attention, should 
be instantly dismissed. 



AFTER TWO YEARS OLD. 175 



CHAP. VI. 



CAUTIONS RESPECTING THE TREATMENT OF YOUNG 
FEMALES AT A CRITICAL TIME OF LIFE. 

The passage from childhood to maturity, in fe- 
males, is often attended with symptoms of serious 
malady, the natural consequence of mismanage- 
ment; but I will venture to affirm, that girls 
whose physical education has been, from the be- 
ginning, such as is recommended in this book, 
(and the moral not calculated to counteract it) 
will not be likely to suffer any of the customary 
indispositions. Constant and diversified occupa- 
tions, exercise and amusement, early rising, good 
nourishment, sufficient sleep, and tranquillity of 
mind, will, in all probability bring the most deli- 
cate female through the critical period of her ex- 
istence, with little inconvenience, and no illness. 

If, however, it should happen that, from any 
hereditary defect or other accidental cause, a girl 
should be affected with symptoms of languor, de- 
bility, difficulty of breathing, &c. at the approach 
of that time of life, the aid of medicine may per- 
haps be required, although the regular attendance 
of a physician be unnecessary; and what are 
vulgarly called courses of steel, forcing medicines, 
&.c. &.c. are pernicious. The very idea of being the 
patient of a medical practitioner, and liable to 
take remedies continually, is, sometimes, enough 



176 TREATMENT OF CHILDREN 

to create disease in a person whose nerves are al- 
ready agitated by the vicinity of an important 
revolution in the frame: and, therefore, it should 
be one of the first objects of those, who are about 
a girl in this situation, to prevent her from sup- 
posing herself in bad health, and keep her mind 
as cheerful as possible; at the same time, that 
the advice of a skilful physician may be obtained 
without parade. 

The best medicinal substances in these cases 
are, probably, rhubarb and iron; but if a journey 
to some chalybeate spring (the resort of gaiety) 
should be convenient, that, without doubt, would 
prove the best remedy, as the change of scene, 
the exercise and diversions usual in such places, 
augment the salutary effects of the iron contained 
in the water. 

.Mothers should be very cautious not to keep 
their daughters too much confined to needle-work 
at this period of their lives, but rather to employ 
them in the more active business of the house- 
hold; and let them have as much air and exercise 
as possible: without however indulging idleness, 
which is one of the greatest enemies to health of 
body and of mind. To preserve the physical and 
moral welfare, it is necessary that all should be em- 
ployed inoccupations suitable to their respective 
situations in society ; errors in the nature of era- 
ployments for young girls are so very hurtful, 
that I cannot refrain from hinting, that such as 
only tend to nourish vanity, and to fill the heads 
of females with silly and ambitious notions, are 



AFTER TWO YEARS OLD. 177 

often injurious to their health at the critical pe- 
riod of which I am now treating. 

We should be careful on all occasions, not to 
impede the progress of nature by untimely reme- 
dies; but remain simple observers of what may 
occur, and be ready to administer relief in case 
any morbid symptoms should appear. When the 
periodical evacuation peculiar to females has once 
taken place, it is not to be expected that it should, 
immediately, continue in a regular course: this 
seldom happens; and on the contrary, it is not 
uncommon for many months to elapse without a 
return; and if a young girl, in this state, shows 
no other signs of indisposition, that alone is not 
to be considered as a disease, and attacked with 
medicine, as is too frequently the case. When 
there are any slight complaints, they must be 
treated as on other occasions: head-aches, with 
baths for the feet; sickness of the stomach, with 
bitter infusions;* fever, with alow diet and di- 
luting liquors; and debility, with some preparation 
of iron. But when a young female in this state 
has no symptom of illness, nothing should be 
done ; for the mere delay of the monthly evacua- 
tion, even though it may continue three, six, 
twelve months, or more, should not be considered 
as a disease. 

* I know nothing better for this purpose than the double 
Chamomile, (commonly sold in apothecaries' shops) of 
which a strong infusion should be taken cold, in the quan- 
tity of three ounces, about an hour before breakfast every 
morning. 

11 



178 TREATMENT OF CHILDREN 

I am extremely anxious to impress on my read- 
ers the necessity of not counteracting nature in 
this particular operation, as I have reason to be- 
lieve, that fatal consequences have sometimes 
been the result of the injudicious administration 
of medicines on such occasions. Mothers would 
do well, however, to be more than commonly at- 
tentive to their daughters in these circumstances, 
and to prevent whatever may interrupt the circu- 
lation of the blood, or retard the establishment of 
the constitution; and above all things, those 
who are about young persons, at this period of 
their lives, are earnestly intreated to remember, 
that uneasiness of mind is likely to occasion far 
more injury than drugs can ever remedy. The 
moral feelings are often too little considered, 
and the physical too much; for mothers who make 
no scruple of wounding a daughter's sensibility, 
or mortifying her pride, will yet be very ready to 
cram her with pills and draughts, if she happens 
to look pale, or complain of a head-ache. 

No doubt there are uncommon cases which re- 
quire medical assistance: convulsions of various 
sorts, as well as other alarming complaints, have 
attacked females at this time of life; but I only 
treat of the general course of things, and would 
strongly recommend that when any extraordinary 
symptoms appear, the best physicians should be con- 
sulted; and all quack remedies, and prescriptions 
of ignorant persons, carefully avoided. 

When young girls have arrived at this period 
of existence, they should be informed that the 



AFTER TWO YEARS OLD. 179 

human frame, during those few days, is more sen- 
sible to hurtful impressions than at other times; 
and therefore, they ought particularly to refrain 
from any sort of food which they find difficult of 
digestion, and avoid wetting their feet, or expos- 
ing themselves much to cold. These precautions 
are quite sufficient; for it is, in reality, unwhole- 
some as well as inconvenient to insist on a change 
of diet, and a number of whimsical laws and re- 
strictions to which some persons submit, and which 
I have never known to conduce to the benefit of 
those who practise them. The less alteration that 
is made from their usual habits, by healthy fe- 
males, the better they will find themselves as they 
advance in years; and those who are in a state of 
disease, should have their regimen directed by a 
medical man. 



PART THE FOURTH. 



OF DISEASES COMMON TO CHILDREN' OF ALL AGES, 

CHAP. 1. 

DIVISION OF DISEASES FEVERS. 

The only division of diseases necessary for 
such a work as this is, into Acute and Chronic. 
Acute diseases may he defined — those which 
commence almost suddenly, are produced by some 
immediate cause, accompanied with high fever, 
and end in a short time. Chronic diseases are 
those which come on slowly, and are of long 
duration; they are often the consequences of 
acute maladies, and are generally more difficult 
to cure. 

When a healthy child complains of fatigue 
without an adequate cause, there is reason to sus- 
pect the approach of Fever; and if this first symp- 
tom be followed by head-ache, disgust to food, 
restlessness, unusual heat of the skin, and a quick 
pulse, continuing for a certain time, the actual 
presence of that malady may be inferred. Some- 



DISEASES COMMON TO CHILDREN, &.C. 181 

times, there is an alternate sense of cold and heat; 
but at other times, the cold is not perceptible. 
Great care should be taken to avoid every thing 
which may augment the symptoms; the child 
should be encouraged to lie in bed, and to drink 
plentifully of diluting liquors.* Should there be 
an inclination to vomit, it should be promoted ; and 
if there has been no evacuation from the bowels for 
four and twenty hours, a clyster, or some mild pur- 
gative, may be given; and this treatment will gen- 
erally be found sufficient for ephemeral fevers,"!" 
and slight epidemic maladies of the eruptive kind. 
If there be strong reason to suppose that the 
malady is occasioned.,,by indigestion, and it is ac- 
companied by pains in the stomach and bowels, and 
with a foul tongue, it would be necessary to give 
a purgative medicine immediately.^ Calomel 
will probably be found the most efficacious; and 
if it should have no effect in five or six hours, it 
ought either to be repeated, or assisted by the 
administration of a clyster. If however there be 
a doubt respecting the cause of the malady, and 
there are no pains of the sort above mentioned, 
it will be better to use no other remedy than con- 
finement to bed, and abundance of warm drink. 

* Weak tea, water-gruel, barley or rice water, light lem- 
onade, apple-tea, infusions of balm, sage, &c, currant jelly 
and water, syrup of raspberry, vinegar and water, &c. ; 
and if the child prefbr sugar and water, there is nothing 
better. 

t Which last about twenty-four hours. 

t Vide Appendix. 



182 DISEASES COMMON TO 

Should there arise a difficulty of breathing, ex- 
traordinary sleepiness, or acute pain in any part, 
a physician should be immediately applied to, as 
bleeding might be necessary without delay ; and 
it always requires medical skill, to determine 
when that remedy should be employed for children. 

In general, one of the most alarming symptoms 
that can appear in a child, is that state of stupidity 
and sleepiness which shows the brain to be affect- 
ed; although, in eruptive fevers it frequently 
occurs, even when they do not turn out dangerous. 
It would always be right to call in a physician 
when such a symptom appears; and, in the mean 
time, the feet should be bathed or fomented 
(whichever is least disagreeable to the patient) 
with warm water and mustard and vinegar: no 
medical man will find fault with the application of 
this remedy; and in some cases of stupor or suf- 
focation, it may retard the danger till his arrival. 

Fever in young children, is to be discovered 
more by redness of the face, burning heat of the 
skin, thirst, and restlessness, than by the altera- 
tion of the pulse; if however that be also quick 
and full, it is certainly a corroborating symptom. 
Whenever there is any considerable degree of 
fever, children should be confined to the bed (by 
persuasion, not force;) but it is not, however, ne- 
cessary to keep them very warm: on the contrary, 
no additional covering should be given, nor should 
any thing ever be done to force a sweat ; although 
all precautions should be taken to avoid checking 
any which may naturally arise. Confined air, 



CHILDREN OF ALL AGES. 183. 

sometimes impedes perspiration; and I have ob- 
served that opening a window in an adjoining 
apartment, so as to change the air of the sick 
person's room, often relieves oppression, and pro- 
motes the excretion from the pores: but this would 
of course require the greatest caution, and must 
depend on the season, and also on the situation 
of the patient's apartment, bed, &c. ; as too much 
cold, or a current of air approaching too near, 
might produce dangerous effects. The child, if 
able to eat, should have only the lightest and most 
cooling food, such as stewed fruits, barley or rice 
gruel &.c. &c, and even these very sparingly. 

When a child is suffering under a simple fever, 
the less medicine that is given to him the better; 
but if there be great uneasiness and impatience 
of the heat, a few grains of purified nitre in a 
little barley or rice water, on going to rest at night, 
may be of use. 

Should a severe cough, pain in the chest, or 
difficulty of breathing come on suddenly, great 
benefit may be derived from a sinapism, made by 
wetting coarse mustard with vinegar enough to 
form it into a soft paste, which should be put into 
a very thin rag (or rather gauze,) and applied to 
the chest, so as to touch about as much as is 
usually covered with a blister (about the size of a 
crown-piece, but larger or smaller according to 
ih" age of the child;) and this should be kept on 
till it give sharp pain and make the skin very red, 
which will generally happen in half or three quar- 
ters of an hour: it should then be taken off', and 



184 DISEASES COMMON TO 

the part covered with a bit of soft linen, over 
which a piece of flannel may be laid. Sinapisms 
on the feet require a much longer time to take 
effect, than on any other part; but the complaints 
of the patient soon give notice when they have 
done so. It is necessary to observe some cau- 
tion in the use of sinapisms, as they sometimes 
produce the necessary effect in a few minutes, 
and should not be left on afterwards; and although 
there be no danger of little children being too 
patient, it would be necessary to observe that 
those who are of an age to have resolution, do 
not endure the pain too long. 



(II LP. II. 

INTERMITTING FEVERS OR AGUES. 

Intermitting fevers, or agues (as they are usu- 
ally called) are less common amongst children, 
than adults; and when they do occur, the cause, 
and consequently the method of cure, is more 
doubtful. 

The ague begins like other fevers, with a sen- 
sation of fatigue and uneasiness, which is follow- 
ed by a painful feeling of cold, attended with 
convulsive shiverings, more or less violent: these 
are succeeded by burning heat; the face, which 
was before pale and livid, becomes very red; the 



CHILDREN OF ALL AGES. 185 

headaches, and there is great thirst; and this, 
the second stage, terminates (in the third stage) 
with a profuse sweat. These three stages form 
what is called a fit of the ague, which is of un- 
certain duration; but (generally speaking) the , 
longer it lasts, the heavier is the disease likely 
to prove. In one species of this malady, there is 
no fever on the second day; but, on the third, it 
returns again, and so continues for a longer or a 
shorter space of time; and it is this periodical 
form which marks the nature of the disease, of 
which this species is called the tertian. 

Sometimes the ague returns for a few hours 
regularly every day, and this is the quotidian; at 
other times there are two days free from fever be- 
tween the fits, and the malady is then called the 
quartan. The double tertian is that which re- 
turns every day, but one day severe and the next 
day slight: the third day's fever being the same 
as the first,' and the fourth the same as the se- 
cond. There are many other kinds of ague not 
necessary to be specified here; but any disease 
of this nature, appearing in a child, would require 
the advice of a physician. 

The object during a fit of the ague, is to shorten 
the cold stage as much as possible, the length of 
the others appearing to depend much on that: 
this may be assisted by putting the child into a 
bed well warmed, and applying hot bricks, or 
bottles filled with hot water, and wrapped up in 
flannel to the soles of the feet. Hot drink might 
also be useful; but if it be given during the cold 



186 DISEASES COMMON TO 

stage, the child is apt to vomit, which renders it 
unwilling to drink afterwards; but in the hot 
stage, when there is great thirst, infusions of ar- 
omatic herbs, and light lemonade, may be given 
plentifully; and, when the sweat comes on, the 
child must be kept as quiet as possible.* 

In regard to the medical treatment, I shall 
only say, that if a child who has been subject to 
worm complaints be attacked by an ague, there 
can be no harm in giving a dose of calomel on 
the day after the fit has taken place; and if the 
fever be shorter or slighter on the next day, 
another dose may be given in a few days after- 
wards, always selecting the day on which the 
child is free from the ague. If the disease should 
be entirely stopped by this means, the cure is to 
be completed by giving those tonic remedies ad- 
vised for worms. t To prescribe the bark, and 
other medicines usually necessary for the cure of 
ague, it would require to see the patient; and, 
therefore, the presence of a physician is indis- 
pensable: even when the malady is so slight as 
not to occasion much sickness, if a purge do not 
immediately remove it, medical advice should be 
sought, as some well-adapted remedy would pro- 
bably be necessary to prevent the distemper 
from increasing, or turning into something worse. 

* Many remedies have been proposed to shorten a fit of 
the ague; but I do not specify any of them, as I do not 
think they ought to be given to a child without the order 
of a physician. 

t See the chapter on that subject. 






i 



CHILDREN OF ALL AGES. 187 



CHAP. III. 

ERUPTIVE FEVERS. 

Eruptive fevers are those to which children are 
most liable ; and whenever they are attacked by 
the symptoms of fever already described, partic- 
ularly if there be vomiting, accompanied with 
severe head-ache, stupor or delirium, pains in 
the back and loins, weakness of the eyes, and 
soreness of the throat, the approach of an erup- 
tive disease may be suspected: and especially if 
any epidemic malady of that sort be in the neigh- 
bourhood. Means should be taken to relieve the 
violence of these symptoms; and for this pur- 
pose, the child should be kept quiet in bed, and 
have such acidulated liquors as may be most 
agreeable to it: the feet may be bathed or fo- 
mented; and bits of linen, dipped in vinegar and 
water, may be applied to the forehead and tem- 
ples, changing them frequently. Those who 
have means of obtaining the advice of a good 
physician, for a child in this state, would do well 
to seek for it without delay: and those who have 
not, should be very cautious not to do too much. 
An eruptive disease must take its course; and 
the chief thing necessary, is to avoid every thing 
which may counteract the efforts of nature. In 
young and delicate children, convulsions are 
very common, but not dangerous; and all the 
symptoms preceding these sort of maladies are 



188 DISEASES COMMON TO 

sometimes very severe, without being followed 
by any alarming consequences. I have more 
than once seen violent fever, accompanied with 
head-ache, stupefaction, delirium, and total loss 
of strength, vanish on the appearance of twenty 
or thirty pimples, dispersed over the surface of 
the body. 

Nothing should be done to disturb or to vex a 
child attacked by a fever; as fatigue of body or 
uneasiness of mind, may change a slight, into a 
dangerous malady. The child should be treated 
with the greatest gentleness, kept as silent as 
possible, and if the eyes are affected, in a dark 
room. Eruptive fevers generally continue from 
four-and-twenty hours to four days, before the 
spots appear; and, (except in the small-pox,) 
during that time, the child should be persuaded to 
lie in bed: when it is necessary to change the 
linen or make the bed, the greatest care should 
be taken that the cold air may not strike on the 
skin, and every thing that touches it should be 
warm. 

If an eruption should suddenly disappear, 
(which, by the by, is generally the consequence 
of neglect or imprudence,) and bad symptoms 
follow, such as stupor, delirium, difficulty of 
breathing, violent pain in the head or elsewhere, 
sinapisms should be applied to the feet, and a 
physician immediately called. Sage, and mint or 
balm tea, may be given for drink; and, for medi- 
cine, a few drops of spirit of hartshorn in a glass 
of warm gruel; but no wine, nor any thing of a 



CHILDREN OF ALL AGES. 189 

cordial nature, unless ordered by a professional 
man. I am particular in mentioning this, be- 
cause it is a common prejudice to suppose strong 
liquors proper for driving out eruptions; and be- 
cause there are so many quack remedies for this 
purpose, which are extremely dangerous in their 
effect, and have sometimes occasioned diseases 
to end fatally, which might otherwise have been 
cured. There is no case in which good medical 
advice is more necessary than in this. 

There is a great variety of eruptive fevers 
which have no particular names, and I have seen 
many, of which I could find no description in 
medical books; but, as the chief symptoms are 
usually the same, there is no occasion for a dif- 
ferent manner of treating them. Any which are 
accompanied with a low pulse, and other marks 
of debility, will require the immediate attendance 
of a physician, as it sometimes happens that dan- 
gerous epidemic diseases appear under this form. 



CHAP. IV. 



SMALL-POX COW-POX. 

It is with some hesitation that I mention a mal- 
ady which ought long since to have been banish- 
ed from all civilized countries; but having lately 
been both an ear and eye witness to its continued 
existence, it appears to me that my work would 



190 DISEASES COMMON TO 

be very incomplete, were I to omit treating of one 
of the most dangerous diseases to which children 
can be exposed. 

The small-pox, is epidemic and contagious in 
the highest degree. It is a malady of the most 
dreadful sort, as it not only menaces with death, 
like other violent diseases, but with a diminution 
of the senses, and various sorts of deformity; from 
which even inoculation has not always secured 
the patient. However, although it has often 
taken a most malignant form, and committed rav- 
ages like the plague; yet, it is sometimes mild, 
and (unless mismanaged) productive of no alarm- 
ing consequences. 

The malady commences with slight heaviness 
and inquietude, for some days before the ap- 
pearance of the fever, which shows itself with the 
general symptoms already described, but in a vi- 
olent degree; and the alternations of cold and 
heat are strongly marked; the eyes are red, the 
throat sore, and besides severe head-ache, the 
patient suffers also from pains in the back and 
loins, and sometimes in all the limbs. The stom- 
ach is painful when touched, the nerves are very 
much affected, and young children are liable to 
be attacked by convulsions. But all these symp- 
toms diminish as soon as the eruption begins to 
appear; which it usually does on the third or 
fourth day, in the form of spots resembling flea- 
bites, first about the mouth, then on the chin, the 
forehead, and the rest of the face ; in the course 
of three or four days they spread over the whole 



. 



CHILDREN OP ALL AGES. 191 

body and limbs, and sometimes the face and eyelids 
are greatly swelled. About the fifth or the sixth 
day, the suppuration of the pustules * commences, 
but is not completed till the eighth or the ninth; 
when the spots, having become yellow and full of 
thick matter, begin to dry up, and fall off by de- 
grees, so that the disease generally terminates 
about the fifteenth or sixteenth day. If the erup- 
tion be in great quantity, there is a return of fe- 
ver during the suppuration, and the swelling of 
the face is removed to the hands and feet; but if 
there are only a few pustules, these circumstances 
do not occur. 

This is (as nearly as can be detailed in a few 
words) the usual progress of the mild, distinct 
small-pox; but even in that, there are varieties 
and deviations from the common course, which 
should not surprise those who witness them. Ac- 
cording to the violence of the fever, will generally 
be the eruption; and yet, the most severe febrile 
symptoms have been known to precede the ap- 
pearance of a dozen spots. 

Persons who have the means of obtaining good 
medical assistance, would naturally seek it on 
the first appearance of so dreadful a malady as 
small-pox: but children whose parents cannot af- 
ford the expense of a physician, may get through 

* It is particularly necessary to observe the appearance 
and the duration of the pustules in the small pox, as noth- 
ing else can fix the character of the disease with certainty; 
for other epidemic eruptive maladies have often a perfect 
resemblance to it, in all the preceding symptoms 



192 DISEASES COMMON TO 

the mild species very well without one, (as there 
is perhaps no malady which requires less medicine) 
if there be nothing done to interrupt the progress 
of nature. 

Nothing is so dangerous as close, shut-up 
rooms, additional bed-coverings, and spirituous 
liquors; which are usually recommended, by the 
ignorant, to prevent the eruption from disappear- 
ing, and are the sure means of changing a mild 
into a malignant small-pox. 

A dose of calomel may be given with advan- 
tage on the first or the second day of the fever, 
if there have been no evacuation from the bowels 
within twenty-four hours ; and afterwards, if 
necessary, clysters must be employed for keeping 
them in a proper state. Head-ache should be 
treated as before directed, vomiting encouraged 
by drinking plentifully of water (or sugar and 
water) warm; should there be a looseness, it 
ought not to be checked; but the child should 
have a great deal of rice-water and toast and 
water to drink. Except when calomel is taken, 
acidulated drink may be given during the whole 
course of the disease; and when the heat of the 
skin is very great, the child may be indulged with 
having it cold. The windows of the patient's 
room should be left open as much as possible, in 
dry weather; with prudent attention, however, 
to the season, the climate, and other circum- 
stances. 

In the small-pox, cold air and cold drink are 
much more beneficial than in any other malady; 



CHILDREN OF ALL AGES. 193 

there is also, less occasion for confinement to the 
bed, and the bed-clothes may be diminished if 
the patient complain of their weight or heat. If 
a child in the fever of the small-pox, wishes to 
go to an open window, or out into the air, he 
should be indulged; and, in fact, when there is 
such a desire, it is a good sign, and a proof of 
the absence of some of the worst symptoms. 
Should a child in this state demand food, stewed 
fruit, bread, barley, or rice, may be given; but 
they should not be pressed upon the little pa- 
tient. 

In regard to the bad sort of small-pox, I shall 
attempt no description nor advice, as it must re- 
quire the attendance of a professional man; but 
will only say that if the eruption should appear 
on the first or second day of the fever, with a 
small quick pulse, stupor and debility, the disease 
threatens to be dangerous; and a good physician 
should be sought without delay. 

After the small-pox is over, some purgative 
medicine will be necessary: if the malady has 
been very light, one moderate dose is sufficient; 
but if there has been an abundant eruption, and 
much swelling of the face and extremities, two, 
or perhaps three, would not be amiss. Calomel 
and rhubarb are the most proper medicines for 
this purpose. 

Symptoms of weakness and languor in a child 
who has lately had the small pox, should not be 
neglected, as all violent eruptive fevers are likely 
to develope maladies of debility. 
12 



194 DISEASES COMMON TO 

It is very extraordinary that this fatal distemper 
should not have been eradicated in almost thirty 
years, which have elapsed since the happy dis- 
covery of the Cow-Pox, a safe and secure means 
of preventing it: and nothing is a greater proof 
of the obstinacy of prejudice, than there being 
still individuals who refuse this easy method of 
preserving their children from a malady so uncer- 
tain and so dreadful as the small-pox. This much 
however must be said in their favor, that vaccina- 
tion has frequently been performed in such a 
careless manner as to produce a false cow-pox, 
which is no security against the small-pox: but 
the difference between the false and the true is 
now so well known, that such errors are very un- 
likely to occur; and they may always be avoided 
by employing a professional man of experience 
and reputation; although there is no doubt that 
any young surgeon of good sense, who has atten- 
tively observed the progress of the vaccine half- 
a-dozen times, may be as deserving of confidence 
in this respect as a man of twenty years' practice. 

There are several strong reasons for preferring 
the vaccine to the small-pox inoculation; but one 
alone would be sufficient; which is, that the for- 
mer is never attended with the pain and clanger 
which not unfrequently follows the latter, even 
under the most promising circumstances. I have 
had a great many, and equal opportunities, of see- 
ing both practiced ; and having witnessed several 
instances of the inoculated small-pox producing 
very dangerous as well as painful symptoms, 



CHILDREN OF ALL AGES. 195 

impossible to occur in the cow-pox, I would stren- 
uously recommend all parents to bestow on their 
children, as early as possible, the inestimable 
benefit of vaccination. I have seen this success- 
fully performed on individuals of various ages 
(from one month to twenty years old), and should 
prefer the age of five or six weeks, as children 
so young do not interrupt the progress of the 
pustules by rubbing or scratching, which it is 
difficult to prevent when they are much older. 

Some instances of the small-pox after vaccina- 
tion have occurred, but scarcely more frequently 
than after inoculation of the small-pox. The fact 
is, that this disease does sometimes (though very 
rarely, like other eruptive fevers,) attack the 
same person twice, of which I have known some 
undoubted examples; but it appears positive that 
when the small-pox returns a second time, or 
comes after the cow-pox, it never is attended 
with any fatal consequences. 

I do not offer any description of the cow-pox, 
as it is an artificial malady, and belongs entirely 
to the medical practitioner. 



CHAP. V. 

THE IMEAZLES. 



The meazles is an epidemic and contagious 
malady, to which children are very liable; and 



196 DISEASES COMMON TO 

which seldom returns a second time. In gen- 
eral, the younger they are, the lighter is the dis- 
order; and when not attended with any compli- 
cation, and when the patient is of a good form 
and constitution, there is little to dread. But to 
very delicate children, or the offspring of con- 
sumptive parents, it is often a source of danger; 
and even in its mildest form, it is always a mal- 
ady which requires great care. 

The first appearance of this disease is that of 
a cold, especially in the head; with sneezing, run- 
ning at the nose, weakness and watering of the 
eyes, and sometimes a cough. This continues 
for several days, and is frequently accompanied 
with great peevishness, restlessness, and melan- 
choly. If the meazles be known to be in the 
neighbourhood when a child is in this state, it 
should be a reason for giving the lightest and 
most cooling nourishment : and more care should 
be taken to prevent the child from going out, or 
from being fatigued, than is usually necessary 
for a cold in the head. 

The leading symptom which distinguishes the 
meazles from small-pox and scarlet fever, even 
in the very beginning, is the apparent cold in the 
head; which is a never-failing attendant on this 
malady. The fever commences like other fe- 
vers, but the disease sometimes takes various 
forms, attended with symptoms which require the 
immediate aid of a physician. 

The eruption usually begins to appear on the 
third or the fourth day, in the form of spots re- 



CHILDREN OF ALL AGES. 197 

sembling flea-bites, about the roots of the hair 
and other parts of the face; which, during the 
fifth, sixth, and seventh days, spread over the 
entire surface of the body, in large blotches, 
which are rough to the touch, being raised a lit- 
tle above the skin; the fever, &c. not always 
diminishing (as in most eruptive maladies) after 
the spots begin to come out. Besides the usual 
symptoms of a cold, there is often, at the begin- 
ning of meazles, an inclination to vomit, (which 
should be encouraged,) and also to bleeding at 
the nose: these symptoms generally afford relief; 
and I have observed, that when the nose bleeds 
much, the eyes are not so liable to suffer from 
weakness afterwards. 

As soon as the spots begin to appear, the child 
should be confined to bed, as warmth and re- 
pose assist the eruption; and, even when the 
malady is slight, the room should be darkened, 
as the eyes are always affected in the meazles. 
This, with the addition of plenty of diluting li- 
quors to drink, will in many cases be found suf- 
ficient, without the use of any medicine. Infu- 
sion of herbs, barley, rice, or water-gruel, sweet- 
ened with honey or sugar, light lemonade, &c. 
should be given, as may be most agreeable to 
the child's taste. If there be a wish for food, 
barley, rice, stewed fruit, or jellies of fruit, and 
bread, may be allowed; but no animal food, nor 
any kind of fermented liquor. 

When the cough comes on, a large piece of 
flannel over the chest will sometimes, by keep- 



198 DISEASES COMMON TO 

ing up a constant perspiration, prevent the ne- 
cessity of more irksome applications; but if the 
eruption come out very slowly, and the cough 
and difficulty of breathing increase, a sinapism 
to the chest may be of the greatest service; and 
I have seen it produce the most beneficial effects 
in less than an hour after it has been applied. 

When the fever, cough, head-ache, &c. in- 
crease on the appearance of the eruption, it is a 
sign that the malady will be severe, and means 
must be sought to relieve the painful symptoms. 
The feet should be put into a sinapised bath; or, 
if the child seem weak, they may be fomented 
with flannels wrung out of hot water, with mus- 
tard and vinegar, which may answer the purpose 
as well as bathing, and be preferable on account 
of not fatiguing. 

If there be reason to suspect a foul stomach at 
the commencement of the meazles, a few grains 
of ipecacuanha may be given with advantage; 
and if the bowels cannot be kept free with clys- 
ters, a slight cooling puige may be administered; 
and this treatment will be found to promote, rather 
than check the eruption. 

To relieve the cough, there is nothing better 
than equal parts of oxymel of squills, syrup of 
poppies, and mucilage of gum-arabic, mixed to- 
gether, and given by a tea-spoonful at a time, 
now and then, according to the circumstances 
and the age of the child. 

The air of the room, inhabited by a child in 
he meazles, should be kept of an equal and mod- 






- 



CHILDREN OF ALL AGES. 199 

erate temperature. Too much heat might possi- 
bly occasion a nervous fever; too much cold, an 
inflammation of the lungs. The bed coverings 
should not be increased in this, or in any other 
eruptive fever, as forcing a sweat either by 
clothes or medicines is very hurtful. Nothing 
should be employed for this purpose but plenty 
of warm drink; and infusions of aromatic herbs 
(sage, balm, elder-flowers, &.c.) are very suitable, 
if they can be rendered agreeable to the patient. 

About the third or fourth day from the com- 
mencement of the eruption, the spots grow pale, 
in the same order as they first came out, and the 
skin begins to peel off in little scales; generally 
on the ninth or tenth day, the cough and other 
troublesome symptoms disappear; and in about 
a fortnight from the first attack of the disease, the 
skin returns to its natural color, and no mark 
remains. 

Sometimes the eruption begins to appear on the 
second day, and sometimes not till the seventh 
or the eighth; and either of these deviations from 
the common course are reckoned unfavorable 
symptoms. 

If the eruption suddenly grow pale and flat, it 
is a bad symptom, which would probably require 
the aid of blisters and camphor; but if a physi- 
cian is to be had, he should be called immedi- 
ately, as quite a different sort of treatment might 
be necessary, of which none but an experienced 
practitioner can be the judge. Weakness and 
delirium, (especially of the low muttering sort,) 



200 DISEASES COMMON TO 

and great difficulty of breathing, are bad symp- 
toms, which require immediate assistance: fo- 
mentations or sinapisms to the feet, and a blister 
to the chest, may be applied in this case, without 
waiting for the arrival of the doctor. 

Sometimes there are aphthae (or small white 
spots) in the mouth, which are very troublesome, 
and make children unwilling to drink; but this is 
not an alarming symptom, and only requires the 
local applications already recommended for the 
thrush.* 

There are cases of meazles in which bleeding 
is of the greatest necessity, and others that re- 
quire cordials, wine, kc. he; but these are 
remedies which cannot be employed without the 
advice of u professional man, as they may pro- 
duce the most fatal consequences, if they be not 
used with extreme discrimination. 

If the eyes are much inflamed and very pain- 
ful, and especially if there be a violent head- 
ache, a child who has not yet been bled, may 
have a leech applied behind each ear; but, in 
case the child has been already bled, it will be 
better to apply two small blisters to those parts. 
Bathing or fomenting the feet, will also be ad- 
vantageous on such occasions. 

For a violent pain in the chest or the side, a 
sinapism to the part affected may be tried; but, if 
that does not answer the purpose, and the child 
is very red and hot, with a full strong pulse, one 

* See page 87. 



CHILDREN OF ALL AGES. 201 

or two leaches may be applied to the spot where 
the pain is most acute. 

The camphor mixture or julap might be given 
without danger, by mothers or nurses, in case of 
the eruption suddenly disappearing ; but when 
this medicine is necessary, there are usually 
many symptoms which require the advice of a 
skilful physician, so that it is not likely to be ad- 
ministered without the orders of a medical man. 

In case of violent cough with acute pain (in 
the chest or side,) excessive high fever, delirium, 
great difficulty of breathing, extraordinary stu- 
por, or uncommon debility; a physician should 
be called without delay, as there are various 
complications which may render this malady ex- 
tremely dangerous, and which may be relieved 
by the immediate application of proper remedies. 
Sinapized baths, fomentations, or sinapisms, may 
always be applied to the feet on such occasions 
with safety, and may sometimes keep off immi- 
nent danger till the arrival of the physician. 

Sometimes children have the legs and hands, 
and even the face very much swelled, after the 
meazles; for this, the best remedy is oxymel of 
squills, which may be given with an unsparing 
hand:* but if there be a cough, which this me- 
dicine appears to excite, it may be mixed with 
equal parts of gum-arabic mucilage, which will 

* No doubt it will be understood that the quantity should 
not be such as to excite vomiting. One, two, or three tea- 
spoonsful, three or four times a day, according to the age 
of the child, violence of the symptoms, &c. &c. 



202 DISEASES COMMON TO 

prevent this inconvenience, and not diminish the 
efficacy of the remedy. 

According to the manner in which the meazles 
have affected a child, should be the quantity of 
purgative medicine given afterwards. However, 
in general, two doses will be sufficient, unless 
more be ordered by a medical practitioner. The 
opinion that " a person who has just recovered 
from the meazles cannot be purged too much," 
is a dangerous error. A delicate child will be 
more injured by a purgative medicine too much, 
than one too little; and a few days more of low 
diet and confinement to the house, is much bet- 
ter than a great quantity of medicine. 

Notwithstanding all 1 have said to assist moth- 
ers, in the treatment id' a malady which requires 
so much care, and in which the least neglect 
might 1>" fatal, yet I must again urge the neces- 
sity of immediately applying to a good physician 
in case of any extraordinary symptoms in the 
course of the m< azles, and still more, when it has 
left after it any remains of indisposition; as it 
sometimes requires the utmost skill to prevent 
those chronic diseases, which often result from 
even the mildest species of this malady. 

When a cough continues after the meazles, it 
should nut be disregarded as a thing which will 
wear off, but rather treated like an original dis- 
ease. It often happens that children do not re- 
gain their health entirely, for several months 
after recovering from the meazles; and great 
care should be taken to guard against any other 



CHILDREN OF ALL AGES. 203 

malady which it may occasion, such as dropsy, 
scrophula, or pulmonary consumption, which have 
been known to follow it. If the disease has 
taken place in autumn or in winter, it would be 
prudent to put on a flannel waistcoat next the 
skin, and worsted stockings ; as the best means 
of preventing subsequent maladies, is to keep up 
the natural perspiration. But should the weather 
be warm when the child recovers, the use of flan- 
nel might be oppressive, and do more harm than 
good; however, the greatest care should be taken 
to avoid damp, cold, and draughts of wind, for a 
long time after the meazles; the feet should be 
kept particularly warm and dry, and the slightest 
indisposition examined with attention. Children 
sometimes look pale and ill, for a considerable 
time after the meazles, without having any ill- 
ness; and I have known this sickly appearance 
continue several months, and then go off without 
any bad consequence. 

Great care should always be taken in return- 
ing to the usual habits of life, both with regard 
to diet and exercise; and it is much better to 
restrain a child for a few days more than is abso- 
lutely necessary, than to run the risk of those 
complaints which may follow the slightest impru- 
dence after the cure of the meazles. 

Those parents who can afford it, would do well 
to remove children who have had the meazles 
severely, in the latter end of summer or autumn, 
to a warmer climate before winter. 



204 DISEASES COMMON TO 



CHAP. VI. 

SCARLET FEVER SLIGHTER MALADIES OF THE 

SAME NATURE. 

The scarlet fever is an epidemic and con- 
tagious malady, which in its simplest state, is a 
complaint of little importance, and requires only 
care and a strict diet to bring it to a conclusion, 
without the aid of medicine: but, when attended 
with complicated symptoms, as frequently hap- 
pens, it becomes a very formidable disease. It is 
one of those maladies to which the human frame 
is supposed to bo only once liable, and the younger 
children are, (after the accidents of teething are 
over) the less they suffer from the scarlet lever.* 

The scarlet fever attacks children (like other 
maladies of the same nature) with uneasiness, 
lassitude, peevishness, weight and pain in the 
head, and frequently vomiting. The eruption 
usually appears on the second day of the fever, 
when the skin becomes covered with little red 
spots, which show themselves first on the face, 
and spread by degrees over the whole body, till 
it becomes almost entirely of a bright red color; 
the arms and legs in general being swelled. 
Sometimes, the fever diminishes when the eruption 
appears, but more commonly it continues as be- 

* I have, however, read and heard of the scarlet fever 
returning, but have never seen an instance of it, though I 
have known of several instances of the return of small-pox 
and meazles. 



CHILDREN OP ALL AGES. 205 

fore. There is sometimes a cough, and great 
redness of the eyes, at the commencement of this 
disease, but they are quite different from those of 
the meazles: the cough has not the appearance 
of catarrh, and the eyes are not much offended 
by the light. 

On the sixth day, the eruption grows pale, and 
by degrees disappears; and, on the seventh or the 
eighth day, the skin begins to peel off in large 
scales; and at the same time, there are some- 
times profuse sweats or diarrhoea, and much sedi- 
ment in the urine. 

If there be reason to believe, at the commence- 
ment of this disease, that the stomach requires 
cleansing, a few grains of ipecacuanha may be 
given; or perhaps if there be an inclination to 
vomit, and the child is old enough to listen to per- 
suasion, some warm drink to encourage the vom- 
iting may be sufficient. There is usually an un- 
easiness in the throat from the beginning, which 
should be gargled or syringed (according to the 
child's age) with some cleansing gargle. 

In general, the treatment of this disease is the 
same as that of the meazles, except that in the 
scarlet fever, the drink may be more acidulated, 
as there is not the same danger of exciting a 
cough. Great care must be taken to keep the 
bowels free with clysters and aperient drinks; for 
purgative medicines should not he given, in this 
malady without the order of a physician. 

The same regulations in regard to the tempe- 
rature of the child's room should he observed in 



206 



DISEASES COMMON* TO 



this disease, as in the meazles; but if the weather 
be warm and dry, a door or a window may be left 
open for a few minutes once a-day, to change the 
atmosphere of the apartment; and the greatest 
care should be taken to keep it clean, a matter of 
considerable importance in all contagious ma- 
ladies. 

When the scarlet fever is accompanied with a 
severe ulcerated sore throat, it is very dangerous. 
and requires the advice' of a physician; and, 
should there be a violent head-ache, or any stu- 
por or delirium, he should be called in without a 
moment's delay. If, on account of distance or 
any other cause, the medical practitioner is likely 
to be retarded, the malady should not be neglect- 
ed till his arrival. The throat may be gargled or 
syringed, the feet bathed or fomented; and in 
case of the head being much afFected, a blister 
may be put on the back of the neck, without fear 
of reproof from the physician. A sinapism may 
also be applied to the throat. 

Inhaling the vapors of hot water and vinegar, 
or decoctions of herbs, has been recommend- 
ed for the sore throat, and may be of use where 
not attended with inconvenience; but if a child 
has a severe head-ache, or is very weak, this may 
be too fatiguing, and in that case it would be 
better to syringe the throat, and apply a sinapism 
at once. 

Bleeding is sometimes necessary in this malady, 
and at other times, bark and wine; but it requires 
profound medical knowledge and great judgment 



CHILDREN OF ALL AGES. 207 

to determine when such remedies are to be em- 
ployed; so that no one but an experienced physi- 
cian should prescribe them. 

When the inflammation of the throat is very 
great, local bleeding with leeches, or the applica- 
tion of a blister, may be necessary ; the former 
will perhaps give more immediate relief than the 
latter, but a blister may be more safely employed, 
without the advice of a medical man, than any 
sort of bleeding; and as the quantity of blood 
drawn by leeches is uncertain, and the bleeding 
sometimes difficult to stop, it is better not to ap- 
ply them in this disease without the order, or (at 
least) the permission of a physician. Still less is 
it to be allowed to those who have not studied 
medicine, to administer wine or any other cordial. 
There is, however, a remedy frequently prescrib- 
ed where there is great depression, weakness, 
and a low pulse, which may, in some cases, be 
given without waiting for the presence of a med- 
ical practitioner, and this is camphor. But when 
this medicine is necessary, the symptoms are usu- 
ally such as to require the immediate advice of a 
physician: if by any accident he should be delayed, 
blisters, sinapisms, and camphor julap may be 
employed, both in scarlet fever and in meazles, 
and indeed in any feverish disorder, when accom- 
panied with lowness of spirits, weak pulse, stupor, 
quiet delirium, and other marks of debility; more 
particularly, if they occur in consequence of an 
eruption having suddenly disappeared. 

When scarlet fever is mild, a little care and 






208 DISEASES COMMOX TO 

attention, a few days' confinement to the bed, and 
plenty of warm acidulated drink, will be sufficient 
to cure it; but when severe, the greatest medical 
skill may be required to save the patient's life; 
and when the malady is quite over, the orders of 
the physician should still be implicitly obeyed, as 
frequently after the scarlet fever, the greatest 
dangers occur. 

When the disease has been so slight as not 
to have required the attendance of a profes- 
sional man, the greatest care should be taken for 
some time afterwards to enforce a strict diet, and 
to avoid all risk of getting cold. It would also 
be prudent to give two or three moderate doses 
of calomel and rhubarb, with an interval of five 
or six days between them, before the child be al- 
lowed to return to its usual course of life. Warm 
clothing and nourishing food are necessary after 
the cure of this malady, and some bitter infusion, 
(such as bark or quassia in good white wine,) 
should be given for some weeks. 

There are great varieties of scarlet fever as 
well as of mcazles, and though I have only thought 
it necessary to describe the regular form, yet it 
is however, right to mention that the first attack 
is sometimes very sudden, and requires immedi- 
ate medical assistance. I have known a child of 
twelve or thirteen years old, with a good appetite, 
and every appearance of being quite well at din- 
ner-time, who, in less than four hours afterwards, 
was affected with violent head-ache, sore throat, 
vomiting, kc. which were followed by the worst 



CHILDREN OF ALL AGES. 209 

sort of scarlet fever. When the symptoms are 
thus sudden and severe, a physician should be 
called without delay, as it is a rapid disease; and 
the distance between perfect health and imminent 
danger may be only three or four days. 

It is easy to distinguish between scarlet fever 
and meazles, at least in their regular form. In 
the scarlet fever, the eruption usually appears on 
the second day ; in the meazles, on the fourth. In 
the scarlet fever it is of a bright, in the meazles of a 
dark color ; also the redness of the former is spread 
more over the entire skin than that of the latter; 
and in the meazles, the skin is more rough to the 
touch than in the scarlet fever. After the mea- 
zles, the skin peels off in little scales, but after 
the scarlet fever, it comes off in large pieces. 
Besides these differences, the appearance of 
severe cold in the head is peculiar to the mea- 
zles; and, indeed, the character of each of these 
maladies is so distinctly marked, that any person 
who has once observed the progress of the two 
diseases, is not likely to mistake the one for the 
other. 

In one respect the scarlet fever perfectly re* 
sembles the meazles; the danger is not over with 
the disease, the consequences of which are often 
worse than the malady itself. 

Improper treatment in either meazles or scarlet 
fever, such as keeping the patient's room too cold 
or too hot, giving meat and fermented liquors, Sec, 
may render a disease dangerous which would 
otherwise have been slight. 
13 



210 DISEASES COMMON TO 

Swelled legs, and swellings of the glands of the 
throat, are usual after the bad sort of scarlet fever. 
They require medical advice and much care, but 
with proper attention are easily conquered. 

There are many more diseases of this nature, 
but they are comparatively trifling; and I refrain 
from further details as unnecessary in a work of 
this kind; the directions already given being suf- 
ficient for all sorts of eruptive fevers (whether 
chicken-pox, nettle-rash, erysipelas, Sec, or one 
of those maladies which have no appropriate 
name,) if they are slight; and if they are accom- 
panied with extraordinary or dangerous symptoms, 
the advice of a physician should be sought without 
delay. 



CHAP. VII. 



COLDS AND COUGHS. 



There is no malady more frequently disregard- 
ed (both in children and adults) than a cold; and 
there is none which may lead to wor.se conse- 
quences when neglected. The general cause of 
this complaint is the perspiration being checked, 
either by exposure to a current of air after exer- 
cise, sitting in damp clothing, especially on the 
feet, or sleeping without sufficient covering. 

The symptoms of a cold require no description; 
they are not doubtful; and those diseases which 
in their commencement resemble it, viz. meazles, 



CHILDREN OF ALL AGES. 211 

hooping-cough, or croup, cannot be augmented 
by being treated in the beginning as a cold, nor 
can any bad consequences result from mistaking 
the one for the other during the first few hours. 

There is no better remedy for a recent cold 
than a warm bath for the feet, composed of salt 
and water for very young children, and for those 
who are old enough to explain their sensations, 
water with mustard and vinegar in it. The best 
time for using this is on going to bed at night. 
The heat of the water should be rather more than 
that of new milk; and when mustard* is used, 
the bath should be sharp enough to make the feet 
a little red, after being in it a quarter of an hour. 
If the child can be persuaded to bear it for twenty 
minutes it will be better, but no coercion should 
be used on the occasion; everything that causes 
vexation (except in very extraordinary cases) 
does more harm than good. This remedy is 
useful in all sorts of colds, as it draws the blood 
from the head, throat and chest; and there are 
various diluting liquors, which, taken hot in bed 
after it, will carry off a recent cold in four-and- 
twenty hours: barley or rice water, with honey 
and lemon juice, lemonade, current jelly and wa- 
ter, infusions of various herbs, such as balm, 
sage, elder-flowers, hyssop, sweetened with 
honey or sugar; and perhaps there is nothing 
better than (what I have seen used with great 
success in the south of France) bran-gruel, 

* See Appendix. 



212 DISEASES COMMON TO 

sweetened with honey, and sharpened with a few 
drops of good vinegar. If the throat be sore, a 
bit of flannel should be put round it, which may 
be cut away by degrees when the child is recov- 
ered. 

It is much better to clothe children warmly, to 
give them strong shoes, and to let them go into 
the fresh air, when the day is fine, than to shut 
them up in the house for a slight cold; but this 
need not prevent the administration of remedies 
necessary for the cure of that species of indispo- 
sition. There is no symptom of a cold which 
may not be benefited by putting the feet into a 
warm bath and going to bed immediately after- 
wards. F<t head-aches,* sore-throat, sore-eyes, 
cough, difficulty of breathing, this is always a 
safe and useful remedy; and I have often found 
it of great service to children both for tooth-ache, 
and ear-ache, which so often proceed from a slight 
cold, or partially checked perspiration. 

In case of a severe cough, I know of no better 
medicine than the oxymel of squills, syrup of 
poppies, and mucilage of gum arabic,t already 
advised in treating of the meazles. When the 
sleep is interrupted either by violent fits of cough- 
ing, or that slight obstinate cough which some- 

* It is to be observed, however, that if a bead-ache pro- 
ceeds from indigestion, too much bile, or any other foul- 
ness of stomach, the bath will have no good effect; and 
the complaint is not likely to be removed without vomiting 
or purging. 

1 See Meazles, p. 198 



CHILDREN OF ALL AGES. 213 

times lasts for hours, there is no remedy so effi- 
cacious as a clyster of seven or eight drops of 
laudanum, in about an ounce of tepid water, 
which should be given by a small syringe, very 
gently, so as not to stimulate the bowels to reject 
it. The quantity of laudanum must be more or 
less, according to the child's age and the effect that 
it produces: what I have specified is for a child 
five or six years old; but if it be necessary to 
continue the remedy long, it must be increased 
by a drop at a time ; and when the cough is cured, 
the laudanum must be left off by one drop every 
night; for if it be discontinued all at once, the 
child will not rest well. I have had great expe- 
rience of this remedy, and can answer for its 
beneficial effects. Laudanum administered in 
this way is perfectly safe, and does not affect the 
head or the stomach. 

But with regard to children's coughs, if they 
occur in winter, or in a cold climate, the first 
remedy to be tried is warmth; and covering the 
chest and feet with flannel ; at the same time fire 
should be put in the rooms they inhabit: this will 
frequently cure the first autumnal catarrh, which, 
if neglected, might last with more or less violence 
during a considerable part of the winter. 

Oily medicines should not in general be given 
for children's coughs, and the white emulsion, 
which used to be so often prescribed for them, 
has been sometimes hurtful. There are remedies 
in abundance without having recourse to oils; 
and those which strengthen the stomach, such as 



214 DISEASES COMMON TO 

infusions of aromatic herbs, &c. with plenty of 
sugar, are to be preferred; especially as it fre- 
quently happens that coughs are occasioned, or 
augmented by indigestion or worms. Barley- 
sugar, refined liquorice, sugar-candy, and many 
other things which come from the confectioner's 
shop, are very good for coughs, but they are 
sometimes attended with inconvenience; for child- 
ren, finding the remedies given for this com- 
plaint very agreeable to the palate, repeat the 
cough without necessity; and as this may pro- 
duce bad consequences, it must be put a stop to 
immediately. The best method I know of effect- 
ing this, is for the persons about a child in this 
state, to remark that " as the malady seems to 
be growing worse, it must have some more 
powerful remedy;" then to make a strong decoc- 
tion of horchound, and give a table-spoonful, 
without sugar, every time the child happens to be 
seized with a fit of coughing. This is an excel- 
lent medicine, and which gives no encourage- 
ment to force a cough. I have employed this 
expedient more than once with success. 

When a cold is accompanied with fever, the 
low diet recommended for that complaint is re- 
quisite; and for bad coughs the same precaution 
is necessary; care also should be taken, that 
children do not eat too much at a time of any 
kind of food. 

Children are subject to various kinds of symp- 
tomatic coughs, which are to be cured by remov- 
ing the maladies which occasion them. That 



CHILDREN OF ALL AGES. 215 

which belongs to teething, being usually nervous, 
must be treated as a convulsive malady; that 
which proceeds from indigestion or worms, re- 
quires first a purgative medicine, and afterwards 
bitter infusions; and the best remedy I know, 
when a cough comes on immediately after a rash 
has disappeared, is sulphur, taken in a very 
small quantity every night at bedtime: I have 
known a cough cured by this medicine in a fort- 
night, without the eruption returning. 



CHAP. VIII. 

THE HOOFING-COUGH. 

The hooping-cough is a malady both epidemic 
and infectious; and one of those which do not 
return a second time. It is right to defend child- 
ren from it as long as possible; for it is more 
dangerous the younger they are, and is particu- 
larly so to little infants. Though a disease of 
terrific appearance, yet it is not usually attended 
with danger to children who are well formed and 
healthy, unless some accidental cause, neglect, 
or mismanagement, should occasion it to be com- 
plicated with other maladies. 

It begins like a common cold; and, after some 
days or weeks, is first marked by that peculiar 
sound which distinguishes the disease, and which 



216 DISEASES COMMON TO 

proceeds from the difficulty of recovering the 
breath after it has been lost by the prolonged 
cough. Some medical writers assert that it is 
over in a month; but instances of that kind must 
be rare, as it generally lasts from three to six 
months, and sometimes even a whole year. It is 
very infectious, and children apparently perfectly 
recovered, on being removed, for change of air, 
to a distant village, have been known to commu- 
nicate the disease to the inhabitants of that place. 
For this reason, great care should be taken to 
prevent young and delicate children from ap- 
proaching those who arc but lately recovered from 
this malady. 

When the hooping-cough is slight, it requires 
little medicine; but the diet should always be 
particularly attended to, as any thing heating or 
difficult of digestion may augment the diw 
The greatest care should also be taken, to pre- 
vent children who have the hooping-cough from 
getting cold; but they should not be confined to 
the house, (when there are no feverish symptoms) 
unless the weather be such as to render it abso- 
lutely necessary. They should be well covered 
when they go out; and if the season be not warm, 
thev should wear flannel, which in very cold 
weather, should he next the skin. Their feet 
should be kept particularly warm; and might be 
put into a sinapized bath once or twice a week, 
or at any time that there appears an augmentation 
of the malady. 

If there be any stuffing in the chest, an emetic 



CHILDREN OF ALL AGES. 217 

of ipecacuanha should be given; and a little of 
the same powder once or twice a week, in so small 
a quantity as not to produce vomiting of itself, 
but to assist it when excited by the violence of 
the cough, may be found useful. The state of 
the bowels should be attended to; and if they 
cannot be kept moderately free by stewed fruit, 
honey, broths with vegetables, &tc. &c, it would 
be right to give now and then, enough of infusion 
or of syrup of rhubarb to produce one or two 
evacuations: but a child who has the hooping- 
cough, should never be purged without the orders 
of a physician, as the malady, being in a great 
degree nervous, is likely to be increased by debil- 
itating remedies. 

When there is great redness of the face, diffi- 
culty of breathing, or much fever, a professional 
man should be immefliately consulted, as bleeding 
or blistering may be necessary to prevent dan- 
gerous consequences; and when extraordinary 
symptoms of any kind appear, medical advice 
should be sought without delay, for a malady 
which complications often render fatal. The 
appearances, however, are sometimes alarming to 
mothers when there is in fact no danger: a dis- 
charge of blood from the nose, mouth, or ears, 
when not violent, is not to be considered as a bad 
symptom; and vomiting is always a good sign, 
especially if the child recover immediately after 
the fit of coughing, and has good spirits and a 
great appetite. Care should be taken not to in- 
dulge the inclination for food too far; and the 



218 DISEASES COMMON TO 

quality of the child's nourishment should be par- 
ticularly attended to. When the disease is slight, 
and that no complication threatens, it is not neces- 
sary to prohibit meat, though it should be given 
more sparingly than usual: barley-water, or cur- 
rant-jelly and water, &c. may be used, if plain 
water be not thought sufficient for common drink. 

Children with the hooping-cough should be kept 
as tranquil in their minds as possible, for anger or 
fear are likely to bring on fits of coughing, in a 
malady which affects the nerves so much. When 
the patient is very delicate, or of a consumptive 
family, the first suspicion of hooping-cough should 
be a reason for calling in a physician, as both the 
violence and the duration of the disease should be 
diminished as much as possible ; and there are a 
variety of remedies to which an experienced 
medical man will have rcc<*irse on such occa- 
sions. 

The violence of the hooping-cough may be di- 
minished by slight emetics and opiates, and its 
duration shortened by frequent change of air, 
especially if it be from a cold to a warm climate. 

Neither purging nor bleeding should be emr 
ployed in this malady, without good medical ad- 
vice, though the latter is sometimes absolutely 
necessary. Local bleeding is generally best 
adapted to children (and delicate people;; and in 
case of any sudden inflammatory attack on the 
chest, during the hooping-cough, leeches applied 
to that part may be of use. 

In the absence of the physician, if a difficulty 



CHILDREN OF ALL AGES. 219 

of breathing should occur, a sinapism may be put 
on the chest (as directed elsewhere), and the 
feet bathed; but these are temporary remedies, 
which should not be relied on entirely. There 
are a great variety of medicines for the hooping- 
cough, not necessary to be specified here, as the 
disease, when severe, requires medical advice to 
adapt them to the particular circumstances. I 
cannot, however, refrain from inserting (though 
against a rule I had laid down not to recommend 
any preparation of antimony) a prescription which 
I have used in the cure of great numbers of child- 
ren, with invariable success.* It consists of two 
grains of kermes mineral and six grains of pu- 
rified nitre, with an ounce of simple syrup: the 
powder should be put into a vial with a small tea- 
spoonful of water, and shaken until they appear 
thoroughly mixed, when the syrup should be ad- 
ded; and every time the medicine is given, it 
should be carefully shaken before pouring it out. 
The quantity is from half a tea-spoonful to a whole 
tea-spoonful, three or four times a day, according 
to the age of the child, the violence of the cough, 
and the effect it produces; and great care should 
be taken to give very little at first, as the kermes 
mineral is a powerful and uncertain medicine, 
which acts violently on some constitutions. It is 

" I have been induced to insert this remedy by the cure 
of an infant lately, who caught the hooping cough a few 
days after its birth. Half an ounce more of the syrup was 
added to the medicine, and a quarter of a tea-spoonful waa 
the quantity given at once. 



220 DISEASES COMMON TO 

necessary to pay great attention to the effects of 
this remedy, as it sometimes affects the bowels 
more than is suitable for the cure of the hooping 
cough, although in general it only keeps them in 
a proper state. 

Young children should sleep with the head 
very high, and should be raised up and leaned 
forward whenever they are taken with a fit of 
coughing: indeed, it is recommended on such 
occasions to all who have the hooping cough, to 
stand up and bend forward, as the posture in 
which it gives least pain. 

When this malady, after the first week, is ac- 
companied with fever, it is an unfavorable symp- 
tom, and will require the advice of a physician; 
but when there is no fever or other bad sign, 
there are many harmless things, which a mother 
or a nurse may give to children without asking 
the permission of a medical man. Asses' milk, 
when it agrees with the stomach, is an excellent 
remedy; hyssop tea, or syrup of hyssop, colts- 
foot and pennyroyal, may also be given, when it 
agrees: decoction, or rather jelly of Iceland 
lichen, (which may be made very palatable by 
putting a great deal of sugar and some juice of 
lemon or orange in it,) is very suitable; as are 
also fruit, jellies, and jams. 

Nourishment is necessary in a disease which 
lasts so long; but it is of the greatest conse- 
quence that the nourishment be adapted to the 
state of the malady; when that is the case, much 
medicine may be spared; and, in this disease, 






CHILDREN OF ALL AGES. 221 

(I might say in all diseases,) the less that can be 
given to children, the better. Maladies are not 
so much under the command of drugs, as those 
ignorant of the science of medicine suppose; and 
patients are more likely to be cured of their com- 
plaints who take too little, than too much medi- 
cine. When a great quantity of medicines have 
been administered, the sick person has first to 
recover from the original disease, and afterwards 
from the debility occasioned by the remedies, in 
many instances an unnecessary addition. 



CHAP. IX. 



SORE THROATS* 



The sore throats of children are most commonly 
the effects of cold, but not always: they are some- 
times the consequences of bile, and sometimes of 
epidemic diseases. These different sorts of sore 
throats require different modes of cure, but none 
of them can be increased by being mistaken for 
a cold, and treated as such in the beginning; that 
is to say, with warm baths for the feet, flannel 
round the neck, and warm diluting liquors. This 
treatment will, generally, remove the sore throat 
proceeding from a cold very speedily; but the 
others require the aid of medicine. 

A sore throat, which is caused by redundancy 



222 DISEASES COMMON TO 

of bile, will have occasion for emetics or purga- 
tives, perhaps both; and that which arises from 
epidemic contagion must be treated according to 
its peculiar nature, of which no one can judge 
but a physician, who has had opportunities of 
seeing the effects of the disease on various indi- 
viduals. For this reason, it would be right to 
seek ^ood medical advice for both these sorts of 
sore throats, especially as it might be hurtful to 
mistake the one for the other, if they should re- 
quire contrary methods of cure, as is sometimes 
the case. 

The moment a child complains of a sore throat, 
a piece of flannel should be put round the neck, 
the feet bathed at bed time, and some warm acid- 
ulated liquor given before the child goes to sleep. 
Lemonade, currant jelly, or syrup of raspberry, 
vinegar and water, or honey and water, with a 
verv few drops of good vinegar, would be suita- 
ble for this purpose. If the child be not better 
next day, and has evident symptoms of a cold, 
confinement to the house may be necessary, and 
the same remedies may be repeated at night. A 
little bit of black currant jelly, or a teaspoonful 
of honey, with two or three drops of vinegar to 
sharpen it, may be given four or five times .a day ; 
and if the child be old enough to gargle,* barley 
(or plain) water, with honey and a very small 

• There are many other suitable gargles, but I mention 
this as the simplest and easiest to provide. I have lately 
heard milk recommended as an excellent gargle by an 
eminent physician. 



CHILDREN OF ALL AGES. 223 

quantity of vinegar, (if there be much, it will 
irritate and do mischief,) may be used for this 
purpose as often as appears necessary. 

In any violent or sudden attack of sore throat, 
the advice of a professional man should be im- 
mediately sought for; but in case of his arrival 
being delayed, and the malady accompanied with 
head-ache, flushed face, great heat of the skin, 
and difficulty in swallowing or breathing, a large 
blister may be applied to the throat or the chest, 
(which ever seems most affected) ; the feet may 
be put into a sinapized bath, or be fomented; at 
the same time, the child should be persuaded to 
drink plentifully of acidulated diluting liquors. 
This treatment may sometimes give relief very 
speedily, but that should not be a reason for 
neglecting to consult a physician, as other re- 
medies might be necessary to complete the cure, 
and to prevent a relapse. 

After a child has recovered from a bad sore 
throat, it will he prudent to keep the neck cov- 
ered for a long time, especially at night and on 
going out, if the weather be cold; as it is a 
malady which leaves the part so weak that those 
who have had it, are liable for a long time to 
slight returns of sore throat, even when the great- 
est care is taken. Children who are old enough 
to gargle, may derive benefit from an infusion of 
bark with a few drop9 of vinegar in it, which is 
to be used cold, merely to strengthen the part 
after the malady has been completely cured. In 
leaving off flannel, or any other covering which 



224 DISEASES COMMON TO 

has been employed to keep the throat warm, care 
should be taken to do it by slow degrees, and not 
till the worm season. 

For that sort of slight sore throat, in conse- 
quence of cold, which occasions a swelling of 
the tonsils, without any great pain, head-ache, or 
fever, it is not necessary to teaze a child with 
gargling, as it will be sufficient to apply a piece 
of flannel to the part, and bathe the feet at night. 
The flannel should not be fastened round the 
neck, but put under the chin, and drawn up over 
the ears so as to cover them entirely, but not go 
higher up, as it is very unwholesome to heat the 
head of a child. By having the flannel of a proper 
length, and making two holes in each end of it, 
a bit of narrow ribbon may be used to fasten it, 
by tying on the top of the head, instead of letting 
the flannel be so long as to have the two ends of 
it meet. The external swellings may be rubbed, 
now and then, with a mild soap liniment,* which 
will help to cure it speedily; but this is only for 
swellings occasioned by a cold, as any thing of 
the nature of scrophulous tumors should have 
no outward applications, except by order of a 
physician. 

Children subject to sore throats should have 
the feet kept very warm, and should be particu- 
larly guarded against sitting in wet shoes and 
stockings. Slight sore throats recurring fire* 

* Prepared by dissolving as much scraped soap as three 
ounces of boiling water can melt, and then adding to it an 
ounce of camphorated spirit. 



CHILDREN OF ALL AGES. 225 

quently, and lasting a long time, would require 
the advice of a professional man, as they may 
proceed from an inclination to scurvy, or some other 
chronic malady, which ought not to be neglected. 



CHAP. X. 



THE CROUP. 



The croup is one of the most formidable mala- 
dies to which children are liable: it is not con- 
sidered a contagious disease, by medical writers, 
(though there seems to exist in some families a' 
predisposition which favors that supposition,) but 
it is often epidemic, and the state of the atmos- 
phere is usually the principal exciting cause of it. 
Cold, damp seasons, such as produce epidemic 
catarrhs, are supposed to occasion the croup; and 
some physicians have expressed their opinion, that 
leaving the bosoms and arms of children bare, 
in cold weather, is likely to cause this malady. 

The croup is a violent inflammatory disease, 
which begins with symptoms of a slight cold, a 
day or two before the extraordinary sound of the 
voice and cough, which peculiarly distinguish it 
from all other maladies, be observable; but, when 
once that appears, all the heat and restlessness 
of fever, with a quick full pulse, and difficulty of 
breathing (but not of swallowing) come on rapidly. 
When the disease becomes severe, it is generally 
14 



226 DISEASES COMMON TO 

recollected that it had been preceded by a cold so 
slight as to have been disregarded. It is a great 
error to neglect the least appearance of indisposi- 
tion in a child, when we consider how rapid in 
their progress, and how fatal in their effects, are 
some of those very diseases, which may be pre- 
vented or lightened by extreme attention in the 
beginning. 

The slightest cold should immediately bring 
to our recollection the ideas of croup, quinsey, 
and inflammation of the lungs, and we should be 
on the watch to check their progress, or to di- 
minish their violence. I do not mean to say that a 
child should be confined to the house, and treated 
as if it was sick for every trifling cold; but it will 
certainly be prudent to bathe the child's feet be- 
fore it be put to bed; and after it is asleep, to ob- 
serve attentively whether the breathing be natural, 
or whether there be any extraordinary appearance 
about it. 

In case of any difficulty or wheezing sound in 
drawing the breath, it would be right to give an 
emetic: if the uneasiness be not great enough to 
disturb the sleep entirely, it may be delayed till 
morning; but if the child be wakeful and restless, 
it should be given immediately. Syrup of squills 
with ipecacuanha powder is a very proper medi- 
cine for young children, and if the complaint be 
slight may possibly remove it; but, if the vomiting 
occasioned by it does not procure speedy relief, 
a physician should be instantly called, lest the 
malady should be the croup, and require more ac- 
tive remedies. 



CHILDREN OF ALL AGES. 227 

Bleeding, blistering, antimonial emetics, and 
strong purgatives, are frequently necessary in this 
disease; but as they should not be employed with- 
out the orders of a medical man, I shall give no 
directions respecting the administration of such 
remedies. 

It is difficult to distinguish, and impossible to 
describe, the particular sound of the croup, which 
has been compared to the crowing of a young 
cock; but those who have once heard it are not 
likely to be deceived. Those who have not heard 
it, should be on their guard against mistaking for 
it a sort of hoarse, croaking cough, to which some 
children are liable on getting even a slight cold, 
and which is usually of little importance, (requir- 
ing only the common remedies,) though it has 
sometimes been turned into a serious malady, by 
being treated as the croup. For this and many 
other reasons, the slightest suspicion of the croup 
should be a motive for seeking the very best 
medical advice, to avoid the risk of creating 
disease by injudicious management. 

It sometimes requires a great deal of judgment 
to distinguish between croup and nervous asthma, 
especially when those about the patient are pre- 
possessed with a notion that the disease can be no 
other than the croup ; and there is no case in 
which it is more dangerous to trust to persons of 
litilc experience, as the debilitating treatment ne- 
cessary for the croup is very different from that 
required in nervous asthma. 

There is no malady in which it is more neces- 



228 DISEASES COMMON TO 

sary to act with implicit obedience to the attendant 
physician than in the croup, as the rapidity of its 
progress allows no time to retrieve errors or atone 
lor neglect; and nothing but the most active re- 
medies can preserve the life of the patient. 

The slightest uneasiness in the throat or the 
chest of a child should be immediately attended 
to, as it is not impossible that this dreadful ma- 
yady, as well as some others of the same nature, 
might be checked in the first stage, by bathing 
the feet, covering the throat and breast with 
flannel, and diminishing the quantity of food. An 
emetic of ipecacuanha may be safely administered 
to a child of any age who appears to be threat- 
ened with inflammation of the throat or chest, but 
antimnnial vomits should not be given without the 
orders of a physician. Children vomit with more 
facility than adults, but if is difficult to prevail on 
them to drink sufficiently: this difficulty is moch 
increased when they are required to swallow 
chamomile tea, or other nauseous liquids: but 
these are by no means necessary, as warm water 
With sugar in it, or weak tea, will answer the 
purpose as well, without being so disagreeable to 
the patient. In this malady (and indeed in all 
other maladies) children should be tcazed as lit- 
tle as possible. 

It appears certain that children who have once 
had the croup are very liable to returns of it, for 
which reason they would require particular atten- 
tion Their throats, chests, and arms, should 
be protected from the cold air; their feet should 






CHILDREN OF ALL AGES. 229 

be kept very warm ; and it would also be pru- 
dent to have accurate directions from the physi- 
cian, by whom they have once been cured, re- 
specting the precautions to be used for prevent- 
ing a return of the disease, and the mode of 
treating it, in case of any sudden attack. 



CHAP. XI. 

THE MUMPS. 

The mumps is an epidemic and infectious dis- 
ease, supposed to be one of those which do not 
return a second time; it requires little medical 
aid, but very great care. 

It consists of a swelling of the glands about 
the throat and neck, sometimes at one side only; 
but more frequently at both, often increasing to 
a prodigious size, and being always accompanied 
with more or less fever. About the fourth day it 
is usually at the height ; from that time gradually 
decreases, and in a few days more, disappears. 
If not increased by neglect or imprudence, it is 
a complaint of little importance; but if a child 
who has the mumps be exposed to cold, the mal- 
ady may take a very serious turn, and require the 
aid of a physician, which should be sought with- 
out delay, when any extraordinary symptoms 
appear. 



230 DISEASES COMMON TO 

The object in the cure of this disease must be 
to encourage both general and local perspiration; 
the former, by keeping the child in bed, and giving 
plenty of warm diluting liquors; the latter, by 
covering the parts carefully with soft flannel or 
fine wool thoroughly heated. 

The proper diet is that prescribed for acute 
diseases in general, and the bowels should be 
kept moderately free, by clysters or the mildest 
laxative medicines. 

After the malady is completely over, it may 
perhaps be right to give a purgative medicine 
before the patient returns to the usual habits of 
life; but this must depend on the constitution of 
the individual, and the manner in which the disease 
has appeared. 

In countries, where this malady particularly 
prevails, a stranger would always do well to con- 
sult a physician resident in that place. 



CHAP. XII. 

DIARRH(EA DYSENTERY CHOLERA MORBUS. 

A diarrhea or looseness, in which there is a 
considerable discharge from the bowels without 
pain, is often a malady* of small importance, re- 

* The looseness which occurs after tedious maladies is of 
quite a different nature, and generally proves fatal : the 
advice of a skilful physician may, however, be beneficial. 



CHILDREN OF ALL AGES. 231 

quiring no medicine; but merely strict attention 
to the diet and general habits of life for a few 
days. If a child who is attacked by this complaint 
has been accustomed to meat and fermented li- 
quors, the quantity of these should be much 
diminished; but, as it often happens that indispo- 
sitions of this nature are accompanied with a very 
good appetite, such food should be provided as 
may satisfy hunger, be of easy digestion, and 
afford sufficient nourishment. Broths, jellies, 
sago, rice, &c. may be allowed, but vegetables 
and fruit would be better avoided: should there 
be wind in the stomach or the bowels, lemon-peel 
or ginger-tea may be given. The greatest care 
should be taken that the child be not exposed to 
damp or to cold; and the diet should still be attend- 
ed to for some time after the diarrhoea is cured. 

In this malady, it is sometimes necessary to 
give medicines immediately. If a diarrhoea be 
violent, and continue more than one day; or if it 
be accompanied with loss of appetite; but espe- 
cially if there be much pain in the bowels, there 
should be no delay in administering the appro- 
priate remedies. The least sickness of the sto- 
mach indicates the necessity of an emetic, and 
there is nothing so well adapted, for this purpose, 
as ipecacuanha. A dose of rhubarb should be 
given, on the next day; and if that does not en- 
tirely remove the looseness, small quantities of 
rhubarb* and ipecacuanha may be given for a 

* One grain of rhubarb and Haifa grain of ipecacuanha, 
two or three times a day, may be given to a child of nine 
years old. 



232 DISEASES COMMON TO 

few days. At the same time, the child should 
drink plentifully of rice water, sweetened with 
very white sugar, which is one of the hest reme- 
dies possible, in all bowel complaints to which 
children are liable. 

Diarrhoea may be produced by many causes; 
such as indigestion, cold, worms, bile; and ac- 
cording to the origin of the disease, must be the 
mode of treating it. That which is occasioned 
by indigestion, will probably be removed by the 
above mentioned remedies: a diarrhoea brought 
on by imprudent exposure to cold or to damp, 
may be cured by lying in bed, bathing the feet, 
and drinking warm diluting liquors, to recall and 
promote the checked perspiration; but if that 
be not sufficient, rhubarb and ipecacuanha (as 
already directed) may be given. When worms 
or bile have occasioned the looseness, a purga- 
tive medicine should be immediati lv administer- 
ed: castor oil, when it can be procured good, is 
one of the best for this purpose; but when that 
cannot be obtained, some preparation of rhubarb, 
may be employed. To a child, who is old enough 
to be reasonable, a dose of powdered rhubarb, 
with magnesia, may be given; but, for little child- 
ren, probably syrup or infusion of rhubarb would 
be more suitable. 

Some children are liable to have the bowels 
affected whenever they are vexed: this is occa- 
sioned by too much bile; and generally cures it- 
self by the evacuation of that substance; but it 
requires great attention to the diet, and if accom- 



CHILDREN OF ALL AGES. 233 

panied with much pain, some mild purgative. In 
bilious complaints, which are usually attended 
with fever, a low diet is necessary; but if there 
appear to be much nervous irritation, a few drops 
of spirit of hartshorn or of ether may be admin- 
istered. It is scarcely necessary to add, that 
children of this constitution should have their 
minds kept as tranquil as possible; the frequent 
recurrence of these complaints tending to weaken 
the bowels. 

If, notwithstanding the treatment here recom- 
mended, a diarrhoea continue undiminished for 
several days, it would be right to consult a phy- 
sician, who might be able to discover the cause 
of the disease, and prescribe the proper remedies; 
for astringent medicines are sometimes neces- 
sary, and it is impossible to say when they can 
be administered with safety and advantage, unless 
the exact state of the particular case be known. 
Persons who have the care of children should 
always remember, that there are no medicines so 
dangerous as those which suddenly stop a diar- 
rhoea. 

The Dysentery is an inflammatory disease of 
the bowels, which is frequently epidemic and 
contagious, but it may be produced by damp 
clothing or by improper food. It is often occa- 
sioned by sudden changes of the weather from 
heat to cold, by which the perspiration is rapidly 
checked; and this is the variety of the disease to 
which children are most exposed. In countries 
where figs abound, it is often the consequence 



234 DISEASES COMMON TO 

of eating too much of that fruit; but in north- 
ern climates, there is not, I believe, any sort 
of ripe fruit which can produce this effect;* 
though it frequently results from eating rancid 
food, such as bad bacon, butter or fish; unwhole- 
some substances, which children, tolerably at- 
tended to, are not likely to partake of. 

The distinguishing marks of dysentery are 
fever, pain, and a constant inclination to empty 
the bowels, with little effect. The evacuation in 
this malady is of various sorts, more generally 
blood and mucus than any thing else: sometimes 
there is a great discharge of blood, sometimes 
very little: and not unfrequently there is mucus 
only, without any blood, though the vulgar name 
of bloodij flux sometimes leads into error on this 
subject. There is little or no evacuation of the 
usual excrements; ami when they do appear, it 
is generally in the form of sheep's dung, mixed 
with mucus and blood. 

In diarrhoea, there is great evacuation from 
the bowels, with comparatively little pain, and 
seldom any fever: in dysentery, the pain and 
fever arc great, but the evacuation small. The 
pains in diarrhoea are severest just before the 
bowels are emptied, and are relieved by it; those 
of dysentery are sometimes much worse after, 
than before. Diarrhoea is often cured without 
any medicine; a thing which rarely, if ever, oc- 
curs in dysentery. 

* A moderate quantity of ripe food is salutary, but all ex- 
cess should be carefully avoided. Am. Ed. 



CHILDREN OF ALL AGES. 235 

When there is an epidemic disease of this na- 
ture in the neighbourhood, on the slightest de- 
rangement of a child's bowels, it would be right 
to apply remedies; and if convenient, to consult 
a skilful physician. 

The dysentery is frequently accompanied with 
an inclination to vomit, which should be promot- 
ed by a few grains of ipecacuanha (a medicine 
particularly useful in this malady) ; and the next 
day it would be proper to give some purgative, 
as this is a malady which cannot be cured with- 
out thoroughly clearing the stomach and bowels. 
Good castor oil, or some preparation of rhubarb, 
may be employed for this purpose; and after the 
desired effect has been produced, the bowels 
should be kept in a free state, until the pain and 
other bad symptoms are removed. A drink* 
made by dissolving cream of tartar in barley- 
water has been recommended strongly, by one 
of the best writers on this subject; and as the 
disease is usually attended with great thirst, it is 
a remedy easily administered, when made palata- 
ble with a great deal of sugar, and a little lemon 
peel. The same author advises that almond 
milk should be drank plentifully, and when it 
agrees with the stomach, this is likely to be 
useful, both as medicine and nourishment. 

Clysters are of the greatest benefit in this 
malady, as fomentations to the inflamed bowels, 
and should be composed of mucilaginous substan- 
ces, which may blunt the acrimony of the bile, 

* See Appendix. 



236 DISEASES COMMON TO 

such as rice-water, with gum arabic dissolved in 
it, or the same gum mixed with milk, decoction 
of linseed, &.c. Oily clysters are very useful 
when there is no discharge of the natural excre- 
ments, but only blood and mucus; and they may 
be given with infusion of chamomile, when the 
patient is troubled with wind in the bowels. 

This disease, being of an inflammatory nature, 
is frequently accompanied with severe pain in 
the head, for which the feet may be bathed or fo- 
mented, as directed for other maladies; and as it 
is of the greatest consequence to promote per- 
spiration, the child should be kept in bed; and 
when obliged to be raised up or to be moved, the 
greatest care should be taken to guard against 
any possible impression of cold. 

When the fever is high, and the discharge of 
blood great, a physician should be immediately 
called, as bleeding or blistering (perhaps both) 
might I"- in cessary to check the inflammation. 

Extreme cleanliness, and changing the air of 
the apartment, is as necessary in this disease as 
in eruptive fevers; and by attention to these par- 
ticulars, the contagious quality of it may be 
greatly diminished. 

When the stomach and bowels have been well 
cleared, small doses of rhubarb and ipecacuanha 
(as directed for diarrhoea) may be given; or, if 
there appear to be much fever, cream of tartar 
may be used instead of rhubarb. 

As there is a necessity for a great deal of drink 
in a malady of this nature, it should be varied 



CHILDREN OP* ALL AGES. 237 

and adapted to the taste of the child. Rice-water, 
sweetened with white sugar and acidulated with 
a little lemon juice, is one of the best things that 
can be given; barley-water, and thin arrow root 
or salop. prepared in the same manner, are very 
suitable; also linseed tea, if agreeable to the 
patient: currant jelly and water, and toast and 
water, may be allowed; and gum arabic may be 
dissolved in balm tea, and given from time to 
time. 

No sort of animal food or of fermented liquor 
should be allowed in this disease, unless positively 
ordered by a physician on account of some extra- 
ordinary symptom. Perhaps there is no malady 
in which the absolute prohibition of these sub- 
stances is so necessary as in this, in which there 
is an internal inflammation, which may easily be 
rendered fatal by any error in diet. 

Rice, sago, salop, arrow-root, with sugar and 
lemon or orange juice, may be given; and various 
sorts of fruits, such as strawberries, raspberries, 
gooseberries, currants, apples, grapes, &c. may 
be allowed, provided they be perfectly ripe, and 
Buch as have agreed with the child when in 
health; but great care must be taken to ob- 
serve if any sort of food produce wind: and, 
should raw fruit be found to have this effect, it 
may be stewed with sugar, and a small bit of 
lemon-peel or cinnamon added. Stone fruit, ex- 
cept peaches, had better be avoided; and every 
sort of food should be given in small quantities at 
a time. 



233 DISEASES COMMON TO 

If any perspiration appear, great care should 
be taken not to check it; and therefore nothing 
should be given quite cold while it continues; for 
this reason, any fruit that the patient may eat 
during that time, should rather be stewed or roasted 
than raw. 

When all inflammatory symptoms have ceased, 
and there is no longer head-ache, thirst, uncom- 
mon heat in the skin, nor pain in the bowels; and 
that the frequent necessity for emptying them 
appears to be merely the result of habit and weak- 
ness, laudanum may be given in a clyster, (as 
directed for cough,)* from five to thirty drops, 
according to the age of the child and the effect 
produced. 

A child who has just recovered from a bad dys- 
entery, should not be suffered to go out without 
wearing flannel next the skin; and the greatest 
care should be taken to keep the feet particularly 
warm and dry : all cold and damp should be avoid- 
ed, and the diet particularly attended to for a long 
time, as the malady is easily renewed, by the 
slightest neglect or error. Good broths and 
roasted meat, in moderation, rice boiled in milk 
with a little cinnamon, sago, salop, Stc, ripe 
fruit, and vegetables of easy digestion, may 11a 
be allowed with safety ; but all greasy substances, 
and whatever is heating or difficult of digestion, 
should be prohibited. 

It would be well to give two or three grains of 

* See page 212. 



CHILDREN OF ALL AGES. z3y 

rhubarb every day, for some weeks after the cure 
of dysentery ; and if the child complain of any 
uneasiness in the stomach or bowels, a purgative 
dose of some preparation of this medicine should 
be immediately administered. Moderate exer- 
cise, at proper hours, will assist much in restor- 
ing the strength; but both morning and evening 
damp should be carefully avoided. 

There are various sorts of dysentery, which it 
would be superfluous to describe, as the treatment 
here recommended can do no injury in any; and 
when extraordinary symptoms or complications 
occur, a medical man should be consulted without 
delay. 

If a child be attacked by severe vomiting and 
purging, accompanied with violent pain, it may be 
suspected that the disease is cholera morbus, 
a malady so extremely dangerous and rapid in its 
progress, that, although not one to which children 
are liable, yet, as it might occur, I think well to 
make mention of it here. 

Many causes* may give rise to this disease ; but 
the most likely cause is indigestion, or an excess 
of acrimonious bile, which unfavorable weather 
sometimes occasions. Be the cause what it may, 
the evacuation from the stomach and bowels should 
at first be promoted by drinking plentifully of 
weak chicken broth or chamomile tea, or indeed 
any watery liquor that the child finds easiest to 

*The eggs of certain fresh-water fish are sometimes 
capable of producing this effect. I have seen a violent 
cholera morbus occasioned by those of tl e barbel. 



240 DISEASES COMMON TO 

swallow. Clysters should also be administered, 
of rice-water, chicken-broth, or linseed tea; and 
when the stomach and bowels have been well 
cleared, means must be taken to check the vom- 
iting. Balm tea is sometimes useful for this pur- 
pose, or lemonade without sugar; but the most 
efficacious remedy (allowable without the orders 
of a physician) is the saline draught,* sweetened 
with syrup of white poppies, and given in a state 
of effervescence. 

The child should be put into a well heated bed, 
have the feet warmed as directed for the ague,| 
and a pie< e of flannel dipped in warm camphor- 
ated spirits,;}; and laudanum, may be applied to the 
stomach. 

This is one of those maladies in which the 
assistance of a medical man would he immediately 
required, as there arc various remedies which an 
experienced physician might, on seeing the pa- 
tient, be enabled to apply with effect. 

After this malady is quite cured, the greatest 
attention is necessary to prevent a relapse: the 
diet should therefore be very strict, and all cold 
and damp should be carefully avoided, as well as 
all vexation and agitation of mind. 

* See page 121. t See p. 185. X See Appendix. 



CHILDREN OF ALL AGES. 241 



CHAP. XIII. 

HYDROCEPHALUS. 



Hydrocephalus (or Water on the Brain,) is 
one of the most fatal maladies which can affect a 
child; and it frequently happens that the propen- 
sity to it, is not suspected till an acute fit of the 
disease destroys the patient, though there may 
have been numerous preceding symptoms to give 
warning of what might be apprehended. 

Head-aches in children of any age should 
never be neglected, especially if violent and of 
frequent recurrence. Parents get accustomed 
to this sort of malady, and one often hears people 
say, " It is only worms," or it is "only an indi- 
gestion;" or, perhaps, that "the child inherits 
the complaint;" which is therefore disregarded 
until dropsy of the head suddenly appear, with 
all the signs of imminent danger. 

When a child is subject to frequent pains in 
the head, a good physician should be consulted 
without delay, and more particularly if the head- 
aches have been preceded by a tendency to ma- 
ladies of debility, or there is any reason to sus- 
pect a scrophulous taint in the blood. The same 
constitution to which this last disease belongs, 
has generally an inclination to hydrocephalus, 
which has often been developed by blows on the 
head, or by the imprudent cure of eruptions. 

When there is reason to suppose that water is 
15 



242 DISEASES COMMON TO 

collected in the head, bleeding and purging are 
generally necessary, and these would require the 
best medical advice: in fact, hydrocephalus is one 
of those maladies in which, when once developed, 
nothing can be effected without the aid of a phy- 
sician, though much may be done to counteract 
the predisposition to it. 

Symptoms of this disease (especially in very 
young children) are often mistaken for those of 
other maladies; and it has sometimes happened 
that indispositions occasioned by water on the 
brain have been ascribed to teething or worms, 
which do, indeed, frequently offer appearances 
so similar as not to be distinguished but by a very 
experienced physician. 

Languor, sleepiness, heaviness of the head, 
vomit inir. aversion to light and noise, especially 
if accompanied by sudden lit-; of screaming, are 
to be considered as symptoms of hydrocephalus: 
but a squint* coming on suddenly, or the disap- 
pearance of one which has hitherto been habitual: 
in short, any extraordinary change in the natural 
position of the eyes, is one of the strongest 
characteristic signs of water in the head. The 
best medical advice should be sought without 
delay, whenever the above mentioned symptoms 
appear; as the malady may sometimes admit of a 



* To spare unnecessary alarm to young mothers, I think 
it right to mention here, that new-born infants frequently 
squint, before they have learnt by experience how to use 
their eyes. 



CHILDREN OF ALL AGES. 243 

cure, if attempted in time, and with sufficient 
skill and energy. 

The means to be used for preventing this fatal 
malady are the same which are advised for scro- 
phula* and rickets; and, in addition to these, the 
sinapized bath for the feet (so many times recom- 
mended in the course of this work) should be 
frequently used. This should be instantly re- 
sorted to, in the case of a child being attacked 
Avith acute pain in the head, without waiting for 
the arrival of the physician; and, if he cannot be 
expected for several hours, (as so often happens 
in country places,) a dose of calomel may be 
given; and whatever evacuations the child has, 
in consequence, should be kept; as a skilful prac- 
titioner may draw much information, respecting 
the nature of the disease, by inspecting what has 
passed from the bowels. 

The pupils of the eyes being much enlarged, 
and not contracting in the usual way on the ap- 
proach of light, is considered as a strong symp- 
tom of hydrocephalus: it may, however, be oc- 
casioned by worms; but, at all events, it is a 
proof that the brain is greatly disordered, so that 
whatever can draw the blood and humors from 
that part, must be advantageous: for which reason 
baths and fomentations for the feet should not be 
neglected. 

I do not mention the medical applications re- 
quisite for the cure of this malady, as they are 

* See chapters xvi. and xvii 



244 DISEASES COMMON TO 

not likely to be employed with any good effect, 
except by a professional man of much experience 
and sound judgment. It should be remembered, 
that there is no disease in which the orders of the 
physician should be more strictly obeyed than 
this of hydrocephalus; and particular care should 
be taken that the child's evacuations be not 
thrown away, when he has desired that they 
should be preserved for him to see. 

Hydrocephalus, though one of the most diffi- 
cult maladies to cure, is by no means out of the 
reach of medicine, and the earlier assistance is 
sought for, the more likely it is to be effectual. 
This disease is of two sorts, the chronic and the 
acute; and it is in the former that medical advice 
is most likely to be of use, and most frequently 
neglected. In the acute hydrocephalus, the 
symptoms of disease arc so violent, that a physi- 
cian is sure to be called, though it seldom hap- 
pens that he can be of any use. However, pa- 
rents should not quite despair in such cases, as 
this is one of those maladies in which a profes- 
sional man will exert all his knowledge, expe- 
rience, and ingenuity; and of late years, some 
children have been recovered from this dreadful 
disease. 



CHILDREN OF ALL AGES. 245 

CHAP. XIV. 

CONVULSIONS. 

Convulsions are unnatural and involuntary 
movements, which may generally be known, even 
by a person who sees them for the first time. 
They frequently affect the whole body, but are 
often confined to one part; and any sudden dis- 
tortion of the head or eyes of a child, maybe con- 
sidered as a convulsion. 

Numerous and various are the causes which 
occasion convulsions in children: those who are 
born with very large heads, as well as those who 
are extremely delicate, are particularly liable 
to them. Even the strongest constitutions may 
be attacked by this malady in consequence of 
teething, worms, or eruptive fevers: but many 
other causes may excite convulsions, in weak 
and sickly children; such as fear, cold and pain, 
either internal or external. Unless in these latter 
cases, this disease does not come on suddenly: 
there are many preceding signs by which an ob- 
serving person may be induced to suspect its 
approach. Disturbed sleep, a frightened look, cry- 
ing in the night, heaviness in the day, momen- 
tary changes of color, grinding the teeth, shut- 
ting the hands fast with the thumb inside, stretch- 
ing the legs out stiff, are some of the signs which 
should put people on their guard against convul- 
sions. 



246 DISEASES COMMON TO 

Sometimes children preserve their senses en- 
tirely in a fit of convulsions, and at other times, 
lose all knowledge of every thing around them. 
This is a malady, which has always occasion for 
the advice of a physician; and the persons about 
the sick child, should be very particular in de- 
scribing to him every circumstance wbich has 
occurred, with truth and accuracy. 

The only remedies which may be employed 
without the orders of a medical man, are the 
tepid bath, clysters, slight emetics, purgatives, 
spirits of hartshorn and camphor julap. Bleed- 
ing, blistering, bark, wine, opium, &c. are often 
necessary; but the judgment of a good physician 
is requisite, to distinguish the cases in which such 
remedies should be prescribed. 

The first remedy for all kinds of convulsions is 
the tepid bath:* those which have been brought 
on by a fright, without any other cause, will 
require only the bath, and a few drops of spirits 
of hartshorn in cold water, both of which (but 
especially the latter) may be repeated three or 
four times in the course of twenty-four hours, if 
it should appear necessary. 

Convulsions occasioned by indigestion or by 
worms, will require a purgative medicine as soon 
as the warm, bath has put a stop to the spasmodic 

* Children from fire to nine months old may be put into 
the warm bath for ten minutes two or three times a day, if 
necessary ; those of a year old, and from that to three years 
old, may remain in the water a quarter or half an hour at 
a time. 



CHILDREN OF ALL AGES. 247 

movements; and if they seem inclined to return 
after the stomach and bowels have been well 
cleared, recourse must be had to spirits of harts- 
horn. 

Sometimes very young and delicate children are 
thrown into convulsions by wind in the bowels, 
and for this the best remedy (after the warm 
bath) is a clyster of chamomile flowers, or of 
water, with about fifteen drops of tincture of 
assafcetida, more or less, according to the age of 
the child and other circumstances. 

When convulsions are known to arise from 
some indigestible substance recently taken into 
the stomach, the best thing will probably be a 
few grains of ipecacuanha. In very young child- 
ren, acidities are capable of producing convul- 
sions, and for these magnesia and rhubarb are the 
best remedies. To cure convulsions perfectly 
their cause must be discovered; for though the 
warm bath is the first resource in all cases of con- 
vulsions, yet, the subsequent treatment of the 
disease must depend upon the occasion of them. 

A violent tempered, or an intemperate wet- 
nurse, may cause a child to have convulsions, 
and the milk should undoubtedly be changed 
when such a circumstance is discovered. A 
mother who has defects of this nature, and can- 
not command herself sufficiently to overcome 
them, should not attempt to suckle her children. 

Convulsions have often been produced by re- 
pelling an eruption; and the proper cure for this 
species of the disease is, evidently, to recall the 



248 DISEASES COMMON TO 

complaint to the surface of the skin with warm 
baths externally, and sulphuric medicines* inter- 
nally. If this cannot be effected, it is probable 
that a perpetual blister, an issue, or a seton, would 
be the most suitable remedy; but the advice of a 
professional man would be necessary to determine 
in such a case. 

Every family of children should be provided 
with a convenient vessel for the warm bath ; and 
also with one for the feet, of such a form that a 
sufficiency of water to cover them above the an- 
cles may be procured in a few minutes. In all 
convulsive maladies, the immediate application of 
the remedies is of great consequence; at the 
same time, that those who are about children, on 
such occasions, should be cautious never to ap- 
pear in a hurry or a fright: a quiet manner of do- 
ing every tiring for them is of much importance, 
and a child subject to convulsions, should be al- 
ways attended by a woman of good sense and 
presence of mind. 

Convulsions sometimes increase at the first mo- 
ment of the child being put into the warm bath, 
but diminish soon after, so that mothers need not 
be alarmed at this appearance. Sometimes child- 
ren have an extreme aversion to the bath; and 
in that case they should not be forced into it; 
but bathing the legs and feet only, or fomenting 
the whole body must be substituted. 

"There are various remedies for this purpose, not neces- 
sary to mention here, which a physician would order. 









CHILDREN OF ALL AGES. 249 

There is no disease in which the assistance of 
a physician is more necessary than convulsions; 
but there is none in which it is more frequently 
requisite to do something before his arrival. The 
moment a child of any age is taken with convul- 
sions, all the clothes should be loosened, and (if 
there be not good reason against doing so) a win- 
dow should be opened, to let the fresh air into 
the room: a warm bath should be prepared as 
quickly as possible, and, in the mean time, if so 
much hot water can be had as is sufficient to fo- 
ment the feet and legs, that should be done with- 
out delay: vinegar may be held to the child's nose, 
and a bit of linen, wet with vinegar and water, 
may be applied tp the forehead. These are all 
things which can do no harm, and may help to 
shorten the fit of convulsions. 

Opium should not be given to children, partic- 
ularly in convulsions, without the advice of a 
physician; but in case of any extraordinary delay 
in obtaining medical assistance, after the stomach 
and the bowels have been well cleared, either 
tincture of castor, spirits of hartshorn, or camphor 
julap may be safely administered; four or five 
drops of the two first, or a spoonful of the last. 
Ten or twelve grains of camphor, well rubbed 
with the yolk of an egg, and mixed with a suffi- 
cient quantity of water for a clyster, may be given 
with good effect. But there is no use in torment- 
ing children with remedies for those convulsions 
which come on at the end of violent or tedious 
maladies, as the cure of such is hopeless. 



250 



DISEASES COMMON TO 



Those convulsions which have been occasion- 
ed by vexation or by terror, require particular 
attention to the moral feelings; at least as much 
as medical assistance: the patients should be 
soothed and tranquillized by all possible means, 
or they will derive little comparative benefit from 
antispasmodic remedies. 

Convulsions which precede the meazles, or 
other eruptive maladies, are not dangerous; and 
in general, only require to bathe or foment the 
feet, and to keep the child very quiet. 

Tooth-ache or ear-ache may occasion convul- 
sions: in both these cases, the feet should be 
bathed: for the former, warm milk and water with 
a little nitre in it, may be used t<> wash the mouth; 
and, for the latter, a few drops of warm milk or 
of oil (it should be rather more than blood-warm,) 
may be put into the ear, and afterwards a little 
bit of cotton heated at the fire.* The ear and 
jaw should be covered either with a piece of hot 
flannel, or (what I have sometimes found more 
beneficial) a thick layer of cotton, large enough 
to cover the whole ear, and all the adjacent parts, 
and tied on with a muslin handkerchief: probably 
fine wool might be still better adapted to this 
purpose. 

To cure convulsions perfectly, the precise cause 
of them must be discovered, and this, it is some- 
times very difficult to do, even with the aid of a 



* If this should not be sufficient, two drops of laudanum 
with three of warm oil may be tried. 



CHILDREN OF ALL AGES. 251 

good physician; chiefly, because the persons about 
children are not sufficiently observant of the vari- 
ous symptoms, which may have appeared before 
the convulsions. If they have been occasioned 
by the impression of too great a degree of cold, the 
tepid bath will probably give instant and effec- 
tual relief, so as to render the employment of 
medicine superfluous. 

It is not necessary to specify here the various 
maladies of this nature, as they may all be com- 
prised under the head of convulsions; and they 
all require immediate assistance, great attention, 
and good medical advice. The best mode of 
preventing.convulsions, is to give children a great 
deal of air and exercise, to keep the bowels suffi- 
ciently free, to have much regard to the moral 
feelings; and in case of any cutaneous disease, 
to have it slowly and prudently cured, and not 
driven in by the injudicious application of exter- 
nal remedies. Great care should be taken to 
avoid all the causes within our power, and to meet 
those which are beyond our power with proper 
remedies and presence of mind. It is certain that 
children, who are treated according to the direc- 
tions given in this book, will avoid many causes 
of convulsions. 

A child who is threatened with epilepsy, has 
generally a frightened and an astonished look, is 
inclined to be melancholy, and has its sleep inter- 
rupted with sudden cries and causeless terrors. 
Fear, surprise, or anger, are capable of exciting 
convulsions or epileptic fits, in delicate children. 



252 DISEASES COMMON TO 

In the last-mentioned malady, they losetheir sen- 
ses entirely, and usually foam at the mouth; and 
when this is the case, it is still more necessary to 
consult a skilful physician than in other species 
of convulsions. The leaves of orange or of lemon 
plants, made into tea, are considered as very 
proper for children who are liable to convulsive 
maladies, especially epilepsy; and may be made 
very palatable to them by the addition of a great 
deal of sugar: but when there has once been an at- 
tack of this disease, it would be prudent to have the 
advice of a professional man with respect to diet 
as well as to medicine. 



CHAP. XV. 



In all indispositions of children, after they are 
weaned,* there may be reason to suspect the 
presence of worms. The symptoms of this malady 
offer a combination of those belonging to many 
others; and it sometimes requires a great deal 
of experience and discrimination, to ascertain the 

* It sometimes happens that children have worms before 
they are weaned, but as this is not a common occurrence, 
the malady cannot be considered as one belonging to sack- 
ing infants. 



CHILDREN OF ALL AGES. 253 

real nature of a disease which assumes such a 
variety of forms. 

Vomiting, diarrhoea, sharp pains in the sto- 
mach and bowels, swelled belly, irregular appe- 
tite, the face pale and sometimes flushed, fe- 
tid breath, difficulty of breathing, head-aches, 
coughs, pains in the limbs, disturbed sleep, ex- 
treme peevishness, running at the mouth, hic- 
cough, itching of the nose, swelling of the upper 
lip, grinding the teeth and starting in sleep, con- 
vulsions, and fevers of various kinds, are amongst 
the symptoms occasioned by worms. 

A very red tongue, or a red stripe down the 
middle of the tongue with the sides foul, is a 
sign of worms; as is also the point of the tongue 
being very red. Children subject to worms have 
generally the pulse more or less intermittent, the 
pupils of the eyes are sometimes much enlarged, 
and the skin under the eyes is black ; the bowels 
are irregular, and the urine often appears as if it 
were mixed with milk. 

A certain number of these symptoms united 
together, gives great reason to suppose the exist- 
ence of worms; as it sometimes happens, that 
many of them are to be met with where there 
are no worms, and at other times where worms 
do exist, several of these signs are wanting. 
Children have passed worms without shewing 
any of the most decisive symptoms previous to 
their evacuation: the fetid breath, which is con- 
sidered as one of the most positive and universal 
signs of worms, has sometimes been wanting; 



254 



DISEASES COMMON TO 



and I recollect to have known an instance of a 
child, about a twelvemonth old, passing one of 
the long round sort, without ever having lost the 
very sweet breath which belongs to sucking in- 
fants in health. 

After the time of dentition, it becomes easier to 
distinguish the indispositions which proceed from 
worms; but while children are cutting their teeth, 
those about them should beware of ascribing 
every morbid symptom to that cause, as many 
are afflicted with worms before two years old. 

It has been said by many medical writers, that 
whenever a child is ill, there is reason to have 
suspicion of worms, which is very true in regard 
to some constitutions; but it is necessary always 
to keep in mind, that the same symptoms, which 
arise from worms, are also frequently the indica- 
tion of more dangerous diseases. Many children 
have died of water on the brain, whose pale fa- 
ces, constant head-aches, want of appetite, dis- 
turbed sleep, &.c. &c. have been ascribed to 
worms; and others, who are suffering under that 
debility, proceeding from a scrophulous consti- 
tution and mesenteric obstructions, have had 
their complaints disregarded, because nothing 
was supposed to be the matter with them but 
" worms, which their elder brothers and sisters 
had also suffered from, and outgrown." For this 
reason it would always be right to consult a good 
physician when such symptoms appear. 

Improper food, or too great a quantity of even 
what is wholesome, may be generally considered 



CHILDREN OF ALL AGES. 255 

as the cause of worm diseases; and were the 
diet of children, during the first four or five years 
of their lives, more strictly attended to, such 
complaints would be much less common than 
they are. Worms are easier to prevent than to 
destroy, and one means of doing this is, to take 
care that infants do not eat fruit or vegetables 
till they are weaned. It is probable, that by un- 
remitting attention to the food of young children, 
worm maladies might be altogether avoided; but 
as this is seldom paid, and as most children are 
liable to such indispositions, it is very necessary 
to know how to treat them. 

The mode of curing these complaints is first, 
to expel or to destroy the worms, and then by 
strengthening the stomach, to prevent their re- 
production. A variety of remedies for the for- 
mer purpose have been recommended; but, after 
repeated trial of a great number, I have found 
calomel the most simple, active, and easy to ad- 
minister. The quantities must be proportioned 
to the age and the constitution of the patient, but 
in general till eight or nine years old, as many 
grains as a child has years, may be given with 
safety:* however, those parents who have the 
means of consulting a good physician, should not 
fail to seek his advice on such an occasion. 

The time I have found best for giving calomel, 

* I think the quantity of calomel here recommended in 
most cases too large ; and as it is a dangerous medicine in 
unskilful hands, it had better not be administered unless by 
the advice of a physician. Am. Ed. 






256 DISEASES COMMON TO 

is at night on going to bed; and some children 
require a purgative medicine next day to make 
it pass off by the bowels: castor oil is very suita- 
ble for this purpose, but perhaps some prepara- 
tion of rhubarb might be still better. No acids 
nor vegetables should be given for several hours be- 
fore calomel, lest it should occasion pains in the 
stomach and bowels; nor, for the same reason, 
should fond of that nature, nor even cold drink, be 
alloiccd the next day, until the medicine has been 
worked off; and great care should be taken that a 
child to whom calomel has been given, be not ex- 
posed to damp or to cold for the next four-and- 
iwcnUj hours. It is of little consequence, in the 
first instance, to ascertain whether the symptoms 
of a foul stomach, Sec. &c, which appear to be 
the effect of worms, are really produced by that 
cause: the object being to clear the stomach and 
the bowels of something which deranges the sys- 
tem: be that what it may, a dose of calomel is 
the best remedy that can be administered. 

I have sometimes had occasion to observe, 
that there are cases in which calomel is more 
effectual for destroying worms when it does not 
purge; and therefore, where the nature of the 
malady is perfectly known, and that purgative 
medicines have been tried without entire success, 
I would recommend to give a small dose of cal- 
omel two or three times at intervals of three or 
four days, and afterwards, castor oil or rhubarb: 
but what is a small dose can only be known by 
experience, as three grains will have more effect 



CHILDREN OF ALL AGES. 257 

on one child, than double that quantity on another 
of the same age. It often happens that the dead 
worms are not expelled till several days after the 
medicines have been taken, and then possibly 
without being observed; so that their destruction 
is to be inferred only from a cessation of the 
symptoms occasioned by them. 

The same debility of stomach which gives rise 
to violent worm diseases, may possibly be the cause 
of others of a different kind; and I have some- 
times suspected it to have occasioned glandular 
obstructions, when they have appeared in children 
who had no hereditary title to scrofulous mala- 
dies. Fevers are often produced by worms; but 
worms are also produced by fevers, being the 
effect instead of the cause; so that a malady is 
not to be called a worm fever, because in the 
course of it, worms have been evacuated. I men- 
tion this, as it has sometimes happened, that in 
consequence of a child having passed worms, in 
a fever to which the attendant physician has given 
another name, the parents have lost all confidence 
in the man of science, and placed their depend- 
ence on quack remedies and the prescriptions of 
the ignorant. An indigestion will sometimes 
assume the appearance of a worm fever; and I 
have seen all the most positive signs of this malady 
removed by a dose of calomel, which produced 
an evacuation of the undigested substances that 
occasioned them. 

When by the use of calomel, or any other 
medicine, the worms have been destroyed, and 
1G 



258 DISEASES COMMON TO 

all symptoms of their presence have ceased, the 
object must be to strengthen the stomach, and by 
that means to prevent their reproduction. This 
is to be effected by every thing that can fortify 
the constitution of the child: bark, iron, rhubarb, 
and infusions of bitter and aromatic herbs, (hys- 
sop, wormwood, pennyroyal, chamomile, Stc. &c.) 
also animal food and wine, much air and exercise, 
in some cases sea-bathing; and in short every 
thing necessary to conquer debility; at the same 
time that the diet should be strictly attended to, 
and no excesses of any kind permitted. 

Even the ripest fruit and best vegetables should 
be given in smaller quantities to children who 
have suffered by worms, than to those who have 
not ; and the greatest care should be taken that 
they do not eat too much of any thing at one time, 
or at irregular hours. It sometimes however hap- 
pens that children who are greatly afflicted with 
worms, have sudden fits of hunger at extraordin- 
ary times, and on these occasions it would be 
dangerous to prohibit food. I have known a child 
of two years old scream dreadfully for something 
to eat in the middle of the night, and at the same 
time complain of a pain in the stomach, which was 
immediately appeased by food. When this symp- 
tom appears, a piece of bread should always be 
kept in the child's bed-room, to give in case of 
necessity; but if worms produce such an effect, 
the malady must be so severe as to require med- 
icine, and a few grains of calomel will probably 
suffice to remove this troublesome symptom. 



CHILDREN OF ALL AGES. 259 

Sometimes a child appears to be almost choaked 
by Mjorms rising in the throat; and for this, a sim- 
ple and secure remedy is cold water with as much 
salt as can be dissolved in it ; two or three spoons- 
ful of which will immediately drive down the 
worms. Indeed common salt is an excellent ver- 
mifuge, and if children could be persuaded to 
take it in sufficient quantity (dissolved in broth) 
to produce the effect of a purgative, it would 
often answer that purpose as well as any other 
medicine. 

Sulphur, camphor, and assafoetida are all useful 
in maladies produced by worms; and there are 
above a hunched remedies advised, which may 
all have good effects at various times, and in 
various circumstances; but there is none so sure, 
and so well adapted to most cases of worms as 
calomel. 

In some coughs occasioned by worms, I have 
found sulphur beneficial : it may be given in honey 
after the child is in bed for three or four nights, 
even if it should slightly affect the bowels. There 
are however other coughs produced by the same 
cause, but arising from irritation of the nerves, 
which would require anti-spasmodic remedies; 
and for these, assafoetida is well adapted, being a 
vermifuge as well as a nervous medicine. Clys- 
ters of assafoetida are often useful for complaints 
produced by worms, especially when they have 
excited convulsions. 

Convulsions occasioned by worms ought, in the 
first instance, to be treated like all others, that is 



260 DISEASES COMMON TO 

to say, with the tepid bath; afterwards calomel 
and assafcetida may be given together, in equal 
quantities, proportioned to the age of the patient. 
Clysters of warm milk have been found very 
useful in pains of the bowels caused by worms; 
and indeed, for the small thread-like worms, 
{ascarides,) which belong to the lower bowels, 
these sort of remedies are particularly adapted. 
I have known instances of children of nine or ten 
years old having derived benefit from salad oil 
and lemon juice mixed together, in the quantity 
of a table-spoonful of each, given on an empty 
stomach, for ten or twelve mornings; and I have 
seen the camphor julap of use in slight spasmodic 
maladies produced by worms. 

In giving strengthening food to children, care 
should be taken that neither the quality nor the 
quantity be such as to occasion fever, an effect 
likely to produce or to augment that debility which 
is one of the chief causes of worms. There is a 
vulgar prejudice against the safest of tonic reme- 
dies and most agreeable of nourishing substances, 
sugar, which is very commonly believed to pro- 
mote the formation of worms in the human body; 
but that it can do no harm is evident by the impos- 
sibility of producing an indigestion with plain 
sugar; and since the middle of the last century, 
many experiments made by eminent physicians, 
have proved it to be an admirable remedy for worms. 
Had I not been already convinced by their 
assertions, the following instance, which has fallen 
under my own observation, would go near to 



CHILDREN OF ALL AGES. 261 

establish the truth of their opinions in my mind. 
A child of eleven months old, attacked by an 
epidemic dysentery in the midst of a very difficult 
dentition, was reduced to such a state of debility 
that her powers of digestion seemed to be lost, as 
every thing she swallowed passed through her 
unchanged. To procure her some sort of nour- 
ishment, she was allowed to eat as much sugar 
as she pleased, for which her instinctive propen- 
sity was so strong that she used to consume many 
ounces both by day and night. The malady con- 
tinuing several weeks, the child acquired such a 
habit of devouring sugar that it was a long time 
before she could be broke of it; indeed it con- 
tinued in a great degree for several years, and in 
case of illness her favorite drink has always been 
sugar and water. She is now a healthy child, 
about seven years old, and never has had the 
slightest appearance of worms, though others of 
the same family have suffered much by them. 
This instance may serve to corroborate the opin- 
ion of those physicians* who have ascribed an 
anthelmintic power to sugar; and is at least a 



* By the information of a friend (whose veracity as a man, 
and skill as a physician, are both of the highest class) I am 
enabled to give another example of the advantages of su- 
gar, in the case of an elderly man, afflicted with worms to 
a great degree, who, after every other remedy had been 
tried in vain, when reduced to a desperate situation, was 
restored to health by the use of that substance in large 
quantities. 



262 DISEASES COMMON TO 

tolerable proof that this substance, so agreeable* 
to the palates of children, is not likely to produce 
worms. 

There is no malady for which a greater variety 
of remedies are recommended than for worms; 
but mothers are earnestly entreated to avoid all 
patent medicines, old women's secrets, and prescrip- 
tions of quacks. If the advice given here pro- 
duces no diminution of the complaints, or so 
little as not to afford consolation, a good physician 
should be consulted immediately, who may point 
out the mode of treating that particular case, and 
distinguish the nature of those maladies with which 
the worm disease may happen to be complicated; 
and in which cither neglect or the use of quack 
remedies might be fatal. 

In treating of the cure of worms, I only mean 
the long, round worm, (lumbricns,) which is in 
shape and size resembling the common earth- 
worm; and the small worms like threads, (ascar- 
ides;) for when the tape-worm (tania) exists, the 
aid of the most skilful professional men is abso- 
lutely necessary; as well as for all those uncom- 
mon worms, the descriptions of which are to be 
met with in medical books. 

* I never saw but one child who disliked sugar, and he 
was a miserable looking being, thin and yellow, and suffered 
much from worms. 



CHILDREN OF ALL AGES. 263 



CHAP. XVI. 

SCROFULA. 

There is no disease in which so much can be 
effected by early and unremitting attention, as 
Scrofula; and it is of the utmost importance 
for mothers to be aware of the first symptoms of 
that malady, and acquainted with the means of 
preventing its approach, and checking its progress. 

Diseases considered as hereditary, and there- 
fore not feared by those who know that they are 
not in the blood of their families, may easily be 
acquired, and sometimes come on suddenly with- 
out any apparent cause.* Scrofula is one of 

* I cannot refrain from making some observations here 
on the strange prejudices which many inhabitants of the 
British islands entertain on the subject of a malady for the 
cure of which there are so many resources, and which is 
not more an hereditary disease than others less within the 
reach of medical assistance. Peisons who make no scruple 
of confessing that they have lost a number of near relations 
by pulmonary consumption, would yet be capable of leaving 
a physician in a dangerous state of ignorance rather than 
acknowledge that they had any reason to suspect a scrof- 
ulous taint in their blood. There are other maladies equally 
to be dreaded, which are also hereditary; but this one ap- 
pears to have an unreasonable and absurd mark of ignominy 
annexed to it, which sometimes occasions parents to deceive 
even themselves, and neglect complaints that are more to 
be assisted by the preventive part of medicine than any 
others, and therefore more in the power of a mother to con 
quer by early and constant attention to her children. 



264 DISEASES COMMON TO 

those maladies which may appear spontaneously 
in any delicate child, under circumstances favor- 
able to its developement, and of which the slight- 
est symptoms should be combated without delay. 
Scrofulous complaints usually appear between 
the ages of two and seven years: delicate, 
relaxed constitutions, and those which have been 
debilitated by previous maladies (difficult teeth- 
ing, worms, meazles, small-pox, &c.) are most 
liable to be attacked by them. Fair, fat, light- 
haired children, with blue eyes, are generally 
supposed to be subject to scrofula; but this in- 
dication does not appear to be so sure in northern 
countries, where many of the strongest individu- 
als come under tbat description; though with 
respect to southern climates, it does seem to be 
a just remark; as, however, the assertion has 
been made (without any exception) by medical 
writers of authority, children of this complexion 
should be particularly attended to; at the same 
time that parents should not be lulled into secu- 
rity, by seeing their offspring with dark eyes and 
dark hair, and without that delicate skin which is 
generally supposed to belong to the scrofulous 
constitution. I have seen the disease make 
great ravages in families where there was not one 
member of them with a fair skin, light hair, or 
blue eyes; and, in fact, it may be produced in 
almost any child by mismanagement; by low, 
damp, and dark habitations, food not sufficiently 
nourishing, a sedentary life, and privation of the 
amusements and open air necessary to the happi- 



CHILDREN OF ALL AGES. 265 

ness of children. To these, perhaps, may be 
added another cause, in the too frequent adminis- 
tration of purgative medicines, especially *mer- 
curial preparations, which are often given to 
children by persons entirely ignorant of their na- 
ture and ultimate effects. 

The best mode of preventing the developement 
of a disease which requires the greatest attention 
to the physical education, is to take care that 
children inhabit dry and airy rooms; that they 
have warm clothing, nourishing food, and a great 
deal of exercise in the open air: they should not 
be debarred from the light and heat of the sun, 
except in cases of weak eyes, or other substantial 
reasons; and they should be indulged in every, 
thing that can exhilarate the mind, as there is 
nothing more likely to prevent glandular obstruc- 
tions than that quick circulation of the blood 
which is produced by gayety. 

When there is any reason for suspecting an 
original taint of scrofula in the constitution, or 
any acquired propensity to the disease, the slight- 
est appearance of debility should be a reason for 
resorting to the use of tonic remedies, such as 
sea-water baths (tepid or cold, as may be most 
agreeable to the child's feelings,) infusions of 
bark, bitter and aromatic herbs, and the different 
preparations of iron. Children, who are liable 



* Almost all the patent medicines and quack remedies, 
which arc prescribed for worms, contain mercury in one 
form or other. 



266 DISEASES COMMON TO 

to scrofula, should be allowed meat as soon as 
they can digest it, and also wine and spices, which 
would otherwise be unsuitable to their age. 

If a child of any age be observed to grow dull, 
languid, and indolent, the cause should be imme- 
diately inquired into, and these symptoms ought 
not to be neglected, as is too often the case; for 
it not unfrequently happens that the persons who 
are about children find them less troublesome at 
the commencement of chronic maladies than when 
in perfect health; and do not discover, till too 
late, that what conduced to the convenience of 
their attendants was only the sign of a disease, 
productive in its progress of far more uneasiness 
to them than the most boisterous vivacity. The 
moment a lively child begins to grow quiet, the 
greatest attention should be paid to find out whether 
this quietness does not threaten indisposition; 
and every means should be employed to exhil- 
arate the mind and to excite to bodily exercise. 

At the beginning of scrofulous maladies, 
children usually grow pale, and often complain 
of being tired without cause; the appetite and 
the general functions of the body become irreg- 
ular, the spirits variable, the face, and especially 
the upper lip, appears swelled, and the jaws are 
more than naturally full. On perceiving any of 
these symptoms in a child of three or four years 
old, it would be right to examine whether there 
be any enlargement of the glands under the jaws 
and chin, under the arms or about the groins; 
and if there be, no time should be lost in apply- 



CHILDREN OF ALL AGES. 267 

ing the proper remedies. The chief of these is 
the sea-water warm bath. Should it, however, 
be inconvenient or impossible to procure this im- 
mediately, a bath of common salt and water (of 
which any one who has ever tasted the sea can 
judge) may be substituted; and though many of 
the component parts of the sea water are wanting, 
yet, from the effects produced by this remedy, 
there is every reason to believe that common 
salt is the most efficacious. I particularly wish 
to recommend this artificial sea-bath, because it. 
often happens, that when a physician orders 
something for a child which the parents cannot 
procure, they give up the case as lost, and totally 
disregard his advice, when it might be possible 
to substitute a remedy almost as good as that 
which he has prescribed. 

The bath prepared with common salt may be 
had every where, and does not require to be 
changed so often as the sea-water; once in five 
or six days is sufficient, whereas the sea-water 
should be fresh twice a week. The temperature 
should be about that of new milk, a little more 
or less, according to the difference of constitu- 
tions; as that which might be too warm for one, 
might be too cold for another. It should, how- 
ever, be as cool as the child can bear with satis- 
faction; but great attention should be paid to suit 
it to the particular feelings of the individual. 
Too hot or too cold a bath might occasion debility, 
and also the risk of catching cold, either by caus- 
ing too much perspiration, or by giving a chill; 



2€8 DISEASES COMMON TO 

but when the temperature suitable to the child is 
once ascertained, it would be right to mark it by 
a thermometer, and always have the water heated 
exactly to that degree. The directions which I 
have already given about the *precautions re- 
quired in warm bathing are not necessary to be 
repeated here, but should always be attended to. 
The child should begin with a bath of ten min- 
utes, and increase by degrees, so as to remain at 
least three quarters of an hour in the water, if it 
be found to agree; but great care should be taken 
that the length of time do not fatigue or vex the 
child, which might counteract the good effects of 
the bath. Children of all ages generally like 
going into tepid water, and if they happen to be 
impatient of staying in it the necessary time, 
means should be found to amuse them, by sing- 
ing, telling stories, or making paper-boats to 
swim in the bath. If the moral feelings of child- 
ren were more attended to, medical prescriptions 
would be 8eidomer necessary, and oftt \ner < JJicacious. 
Every thing that depresses the spirits or irritates 
the temper, must be injurious to constitutions in- 
clined to maladies of debility. 

Children disposed to scrofulous complaints re- 
quire little medicine; but strict attention should 
be paid to their manner of living; they should 
have as much air and exercise as they can have 
without fatigue, and the most strengthening and 
nourishing food. The greatest attention should 

* See page 83. 



CHILDREN OF ALL AGES. 269 

be paid to their digestive powers, which are some- 
times very weak, and it frequently happens that 
things which would appear the best adapted to 
them, do not agree with the peculiar state of their 
stomachs. Strong broths and jellies are amongst 
the aliments one would be most inclined to recom- 
mend; but they will sometimes disagree, and oc- 
casion fever. Sago, salop, arrowroot, &c, which 
are prepared with wine, sugar, and lemon juice, 
where they agree with the stomach and please 
the taste, are excellent food for children inclined 
to debility. Eggs are generally suitable to child- 
ren, and coffee and chocolate may often prove 
medicinal to those of a relaxed, delicate constitu- 
tion.* Chocolate in substance, will agree with 
stomachs which cannot bear it mixed with hot 
water; and a piece of this with bread, and a glass 
of cold water after it, is by no means a bad break- 
fast for a weak child. Good bread, well ferment- 
ed and well baked, is considered, by many emi- 
nent physicians, as more proper food for children 
inclined to scrofula than unfermented farinace- 
ous substances, such as barley, oat meal, &.c. 
&.C.: but I am convinced that if they take suffi- 
cient exercise, this last-mentioned sort of food, in 
moderation, will not hurt them. 

The irregularity of bowels to which children 
threatened with scrofula are liable, should, if 

* I must explain that the chocolate meant here is that 
which is made with sugar, and without any mixture offal, 
flour, &c., in short, such as is usually to be met with in 
Italy. 



270 DISEASES COMMON TO 

possible, be remedied by changes in the diet, &c. ; 
but, when medicine is found to be absolutely ne- 
cessary, the various preparations of rhubarb are 
preferable to any other. In case of worms or in- 
digestion, a dose of calomel may be occasionally 
administered; but rhubarb is the only substance 
of a purgative nature which can be given fre- 
quently without injuring the stomach. Magnesia 
is also a safe medicine, and in case of acidities 
may be joined to rhubarb with advantage. And 
here I must observe, that when a child is subject 
to habitual constipation of the bowels, it is by no 
means sufficient to apply the temporary remedy 
of an opening medicine; but the cause of this in- 
disposition should be sought after, as it may pro- 
ceed either from some error in the child's food, 
from habits of life, or from some beginning malady 
which would require medical advice. 

Children who are inclined to scrofula are 
generally very subject to acidities, for which rhu- 
barb and iron are the best remedies. Small 
quantities of magnesia will usually relieve this 
symptom immediately, but the others are more 
efficacious in preventing the return of it; indeed, 
they are the medicines chiefly to be relied on at 
the commencement of this disease, and when it 
is not hereditary. The irregular fever and white 
tongue will generally be removed in a short time 
by the proper use of these medicines; and the 
nervous irritation, which sometimes prevents 
children in this state from sleeping, may be calm- 
ed by a few drops of spirits of hartshorn or of 



CHILDREN OF ALL AGES. 271 

aether, in sugar and water, after the child is put 
to bed: hut these are remedies which should only 
occasionally be resorted to. 

Among children, who are inclined to scrofu- 
lous maladies, some are very intelligent, and 
others quite the contrary: the former should not 
be encouraged to learn too soon, and the latter 
should be taught late and slowly. Amusing ex- 
ercise should be the great object of both, but care 
should be taken to avoid fatigue. They should 
have all those toys which excite children to use 
their limbs, and in dry weather should be as much 
as possible in the open air. Swinging is an ex- 
ercise particularly adapted for them, especially as 
it may be so contrived, by fixing a seat with a 
back to it on the rope, that a very weak child 
may have a great deal of motion without fatigue. 
When delicate children cannot bave much ex- 
ercise, or are obliged to live in climates where 
bad weather often confines them to the house, 
their bodies should every day be rubbed all over 
with flannels which have imbibed the fumes of 
frankincense, benzoin, amber, &c. In summer, 
their beds should be exposed to the sun, and in 
winter heated by a warming-pan, in which a little 
of one of the above mentioned aromatic substances 
has been burnt. Scrofulous children should 
never be allowed to surfer from cold, (indeed it is 
injurious to all children,) and particular care 
should be taken to change their clothes according 
to the season. 

With regard to the instruction of children 



272 DISEASES COMMON TO 

threatened or afflicted with diseases of debility, 
it is of the greatest consequence that they should 
be taught by persons who will treat them with 
gentleness, and neither irritate nor terrify them, 
but especially the latter. There are no painful 
moral sensations so injurious to children of this 
constitution as fear and shame. Anger irritates 
the nerves, and promotes the morbid secretion of 
bile, but does not depress the spirits and check 
the circulation, like feelings of terror and shame; 
and for this reason it is more hurtful to children 
inclined to glandular obstructions to be frightened 
and mortified, than to be enraged. They should 
be guarded, as much as possible, from every sort 
of moral pain, but more especially from such as 
retard the course of the blood: for this reason 
they should never be left with persons likely to 
treat them with contempt, or to frighten them 
with severe threats or practical jokes. 

There is a scrofulous disease, which does not 
shew itself in swellings of the external glands, 
though it has all the general symptoms already 
mentioned, and requires the same treatment; I 
mean that which particularly attacks the mesenteric 
glands,* and is often disregarded until too late ; 
the large belly which belongs to it being common 
to many maladies of children, and, in fact, if not 
accompanied by other corroborating symptoms, 
brings no proof of a scrofulous complaint; but 
if a child eats a great deal, and yet grows thin 

* The mesentery is a membrane which covers and contains 
the bowels. 



CHILDREN OF ALL AGES. . 273 

and weak, there is reason to suspect mesenteric 
obstructions, and it should be observed what other 
morbid symptoms may be present. 

There are cases in which scrofula attacks the 
bones before it affects the glands; but the preced- 
ing symptoms of general debility and indisposition 
are usually the same, and wherever such symp- 
toms appear, the best medical advice should be 
sought, being often more necessary on such oc- 
casions than in acute diseases. 

One thing, which is to be particularly remem- 
bered in these sort of maladies, is, that although 
much may be hoped from the preventive part of 
medicine when they threaten or first appear, yet 
when (through neglect or any other cause) they 
have made some progress, there are none more 
difficult to cure, nor which require more know- 
ledge, attention, and judgment in the physician. 
Very strong medicines are sometimes necessary, 
and if these be not administered with the greatest 
skill and caution, the consequences may be fatal. 
When, therefore, the advice given in this chapter, 
after three or four weeks' trial, produces no 
change for the better; and that, notwithstanding 
the use of salt-water baths, a tonic diet, much 
exercise, rhubarb, iron and bark, the symptoms 
of weakness, pallid and pulled face, swelled upper 
lip, irregular fever, &c. do not diminish; some 
good physician should be immediately consulted, 
as remedies of the most active nature may be 
required to conquer the disease. 

There is no malady in which delay, or the use 
17 



274 DISEASES COMMON TO 

of quack medicines, is more dangerous than in 
scrofula; for, though the steps of this dreadful 
disease be slow, and the stages in which its pro- 
gress may be arrested numerous, yet when neg- 
lected there is none more distressing or fatal. I 
must, however, again repeat, for the consolation 
of mothers, that a constant and minute attention 
to the prevention of scrofulous complaints will 
generally meet with success.* 



CHAP. XVII. 



This is one of those maladies which are easily 
acquired by children who are neglected or mis- 
managed, and more difficult to cure than to pre- 
vent. Errors in the physical education may excite 
this disease even in children who have no predis- 
position to it; but in those families where it has 

* People should not obstinately doubt of the existence of 
scrofula amongst children who have no hereditary right 
to it, as it is sometimes produced spontaneously, without 
any apparent cause, except that complexion and form which 
are supposed to mark a predisposition to it. I have known 
one individual of a family, (when there were no hired 
nurses) afflicted with this disease to a great degree, though 
a number of brothers and sisters, by the same father and 
mother (themselves free from the malady,) had not the 
least appearance of it. 



CHILDREN OF ALL AGES. 275 

appeared to.be hereditary, the greatest care is 
required to prevent its developement. The same 
causes which produce scrofula are likely to give 
occasion to rickets, and the preventive method 
employed against the one malady is equally proper 
for the other, though the medicinal treatment of the 
two diseases be not exactly the same; so that in 
general, all which has been recommended in this 
book to prevent scrofula, is applicable to the 
rickets, and it remains to the physician to pre- 
scribe what the peculiar circumstances of the case 
may require. 

Rickets generally begin between the ninth and 
the twenty-fourth month, but the commencement 
of the malady is not absolutely confined to that 
period, and it has been known to make its first 
appearance at various ages. It comes on by slow 
degrees: the first symptoms are the flesh growing 
soft and flabby, and the strength diminishing; in 
a short time the child becomes unnaturally grave 
and quiet, and shews a dislike to motion; the face 
appears bloated, and has sometimes a high color; 
the head and belly increase to a great size; the 
wrists and ancles grow too large, the legs become 
crooked, as indeed do all the bones by degrees, 
if means be not found to check the progress of 
the malady. The face changes, and the child 
acquires either a sharp, cunning look, or a silly 
expression of countenance; the faculties of the 
mind are in general superior to those in healthy 
children, but sometimes they arc inferior. When 
the disease has made any progress, the pulse is 



276 DISEASES COMMON TO 

usually quick and weak, the appetite, digestion, 
and evacuations are irregular; teething is late, 
and the teeth are apt to decay soon. All these 
symptoms appear by degrees, as the malady ad- 
vances, and some of them are common to other 
diseases; but they should not be disregarded lor 
this last reason, as they always mark the presence 
of some malady which would require good advice 
and great attention. 

The means of preventing rickets (when a pre- 
disposition to that disease is suspected,) are the 
same which are necessary to prevent the devel- 
opement of other chronic diseases: good air, 
much exercise and amusement, strengthening food 
and warm clothing; high, light, and cheerful 
habitations, apartments fronting the mid-day sun, 
baths, frictions, &.c. Stc. Medical writers are also 
of opinion that children inclined to this malady 
should be weaned early for the purpose of being 
nourished with tonic food. 

On the very first appearance of symptoms, 
which may threaten rickets, a good physician 
should be consulted, as the earlier the disease is 
combated by judicious medical treatment, the 
more likely it is to be conquered; but if permit- 
ted to make any progress, it is with the greatest 
difficulty that it can be stopped; and even if cured, 
it usually leaves those who have suffered from it 
more or less disfigured. When it has been neg- 
lected too long for medical skill to have any power 
over it, it either ends in death by consumption 
and diarrhoea, or in excessive deformity, for which 
there is no remedy. 



CHILDREN OF ALL AGES. 277 

In this malady, the air which is breathed should 
be light and elastic, without being very cold; the 
mattresses on which the patient sleeps should not 
be either very hard or very soft, and great care 
should be taken that there be no lumps which can 
make them uneasy.* Tepid baths, with infusions 
of aromatic herbs, may be useful; also baths of 
brandy and water, or of sea-water either warm or 
cold; sponging the body all over with cold water 
(which is recommended by some in preference to 
immersion,) and rubbing it dry with flannels, and 
frictions of various kinds. Iron, bark, and rhubarb 
have been used with good effects; and the last men- 
tioned substance is undoubtedly one of the best 
medicines that can be given to a child affected 
with rickets, to keep the body sufficiently open, 
to strengthen the stomach, and to prevent diar- 
rhoea, all which are necessary in this malady. 

But little advantage is to be derived from med- 
icine, or suitable diet, baths, &e. if there be not 
a sufficiency of air and exercise; and for this last 
purpose artificial aids are necessary to rickety 
children, as they cannot move like others: they 
will not learn to walk of themselves, and there- 
fore must be taught; but this ought to be done 
very late, with great caution and by slow degrees. 
They should be exercised in swings, riding-chairs, 
and little carriages with springs, to be drawn 
about on smooth roads or fields; but it must be 

III' e "I' horse-hair are preferable to wool; but many 
bhysicians have advised that die mattresses of rickety child- 
ren be stuffed with dried fern, mixed with aromatic herbs. 



278 DISEASES COMMON TO 

remembered that a jolt, a fall, or a blow is par- 
ticularly dangerous to children affected with this 
disease. 

To prevent rickets, a great deal can be done by 
the physical education; but when the malady has 
once begun to develope itself, the advice of an 
experienced medical man is absolutely necessary; 
for though in general it is improper to give much 
medicine for rickets, yet the skill of an experi- 
enced physician is required to discriminate what 
ought to be done. Many persons consider cold 
bathing as a specific in this disease; but I shall 
not recommend any one to try it, without good 
advice, as there are cases in which it might be 
very hurtful. If a strong, healthy child shews a 
tendency to rickets, (which happens now and then 
in consequence of a lazy nurse letting it sit on 
the floor, or lie in the cradle, when she should 
carry it out or dance it on her knees,) the cold 
bath will probably prove an excellent remedy: but 
even in this case, those who have it in their power 
would act prudently by consulting a good phy- 
sician. 

Medical writers strenuously recommend that 
the clothes of children who have this disease 
should be extremely dry; but I consider that as an 
essential point for all children, healthy or un- 
healthy: what should be particularly attended to 
for those who have this or any other chronic mal- 
ady, is, to expose their bedding to the air and sun 
every day, as well as their night-shifts, or any 
other part of their clothing which is to be used a 



CHILDREN OF ALL AGES. 279 

second time before it be washed; and it would 
also be good to burn a little frankincense, (or 
some other aromatic substance) in a chafing-dish, 
for the purpose of fumigating such things. The 
greatest part of the year, children afflicted with 
this malady should wear flannel next the skin; but 
much precaution is necessary in leaving it off; 
indeed, in climates where the heat is never very 
intense, it might be better to keep on flannel all 
the year round, and only to change to a thinner 
kind during the summer months: but this must 
depend on the feelings of the child, and other 
circumstances of the case. 

For a child threatened with rickets who inhabits 
a great city, perhaps one of the best remedies 
would be immediate removal to the country; and 
those parents who have the means would do well 
to try the effects of a warmer climate. 



CHAP. XVIII. 

CUTANEOUS DISEASES ERUPTIONS ON THE HEAD 

ITCH HERPETIC ERUPTIONS. 

Growing children are subject to various kinds 
of eruptions, unaccompanied with fever or sick- 
ness, which sometimes continue a long time, and 
are very troublesome, but of no serious conse- 
quence to their health, unless suddenly or impru- 
dently repelled from the surface of the skin. 



280 DISEASES COMMON TO 

The strongest children are frequently those 
most liable to rashes and eruptions, which they 
outgrow as they advance in years. Sometimes 
these are so slight, that were it not for the impa- 
tience of the children, they would be scarcely 
visible: half-a-dozen spots, like flea-bites on the 
face, and fifteen or twenty scattered over the body, 
would probably escape notice; but that, as they 
generally itch, children are apt to scratch them, 
so as to make sores, by which they become more 
visible and durable than they otherwise would be; 
and mothers, vexed at seeing the beauty of their 
children spoiled, are sometimes induced to employ 
remedies, the pernicious effects of which they do 
not know. 

No medical treatment of the slightest eruption 
should ever be undertaken without the advice of 
a skilful physician: but if the itching be trouble- 
some, the tepid bath may be safely used, and the 
child put into it for a quarter of an hour, just 
before bed-time. The diet may also be changed 
for one of a more cooling nature than usual; and 
fruit, either raw, stewed, or dried, and vegetables 
(if they agree with the stomach) may be given, 
in preference to meat or eggs: milk and whey 
are very proper for drink, but all sorts of fer- 
mented liquors should be avoided ; and if the child 
who is broken out happen to be delicate, and to 
require nourishing food, sago, salop, arrow-root, 
&c. made palatable with lemon or orange juice; 
rice boiled to a jelly, and oat-jelly (flummery*) 

*See Appendix. 



CHILDE.EN OF ALL AGES. 281 

will probably be found suitable. Fruit-jellies and 
jams, with bread, may also be allowed, and, in 
short, every thing that usually comes under the 
denomination of cooling diet. The state of the 
bowels should be particularly attended to, and if 
the kind of food above mentioned, combined with 
a proper quantity of exercise and air, do not keep 
them sufficiently free, (as however it generally 
will,) a little magnesia, or magnesia and sulphur, 
may be given, in such a quantity as to procure 
one or two evacuations: but purgative medicines 
should not be habitually employed without the 
orders of a physician. I mention this especially, 
because many persons suppose that cutaneous 
diseases are to be cured by continual purging, 
which, on the contrary, in many cases, is more 
likely to increase the complaint. 

Children are very liable to eruptions on the 
head, and sometimes a small pimple, which has 
been accidentally scratched, if not immediately 
attended to, may become a spreading and obsti- 
nate disease. The slightest appearance of this 
sort would require great care; and many of these 
complaints might be cured in a few days, by cut- 
ting the hair quite close round the inflamed spot, 
and washing it three or four times a day with warm 
water and soap, continuing to do so for at least a 
week after the part appears to be perfectly cured. 
A pimple or a scratch, of no importance in any 
other place, may easily become a bad sore on the 
head. 

If an eruption on the head be not cured by cut- 



282 DISEASES COMMON TO 

ting the hair and washing the part with soap, it 
would be right to consult a physician, lest the 
complaint should prove to be one of the various 
species of tinea (scabbed head,) which are so 
difficult to cure, and for which the appropriate 
remedies can only be known by seeing the erup- 
tion. 

As there is some reason to suppose the tinea a 
contagious disease, children should be cautioned 
against putting on the hats or caps of those they 
do not know. 

Extreme cleanliness is of the greatest import- 
ance, both in the prevention and cure of cutane- 
ous diseases; and though it may not entirely keep 
them off, yet it will always be of use in diminishing 
their violence, as well as in greatly conducing to 
the comfort of children afflicted with them. 

If a child have the misfortune to be infected 
with the itch, a disease which cannnot be removed 
without the application of external medicines, a 
good physician should be consulted, as the cure 
ought to be effected with great caution, it being 
dangerous to apply repelling ointments to too great 
a portion of the skin at once: but it should be 
remembered that the sooner the cure is com- 
menced, the easier it will be. It is necessary to 
observe here, that young children have sometimes 
slight eruptions so strongly resembling the itch, 
that even a physician, unless he be a man of much 
experience, may be deceived by them; and the 
use of ointments for this malady is by no means 
safe. The best mode of ascertaining the nature 



CHILDREN OP ALL AGES. 283 

of the disease is to give a little sulphur on going 
to bed, for three or four nights together, a remedy 
which can do no injury in any case; and, if the 
eruption be the itch, will throw it out sufficiently 
to prevent mistakes. 

Those violent herpetic eruptions, (vulgarly 
called scorbutic,) which torment and disfigure 
children for a length of time, require the greatest 
care: it would always be better to let them remain 
on the surface of the skin, than repel them with- 
out the positive orders of an experienced medical 
practitioner; as the internal diseases, which may 
follow are far more to be dreaded, than any tem- 
porary ugliness or inconvenience caused by the 
eruption. 

The only safe, and probably the only efficacious 
remedies, are to be found in the various kinds of 
warm baths; and these should, in many cases 
be accompanied with the use of certain internal 
medicines, which a judicious physician would 
know how to adapt to the particular circumstances. 
There are several springs in England, of which 
the efficacy in the cure of such complaints is well 
known, and there are, besides, many ways of com- 
posing artificial baths for this purpose. On the 
Continent, there are numerous sulphureous and 
other hot baths, beneficial for these diseases; and 
no doubt when the additional advantage of a warm 
climate can be obtained, they must conduce much 
to the efficacy of the waters. 

Great care should be taken that the skins of 
children affected with herpetic eruptions be not 



284 DISEASES COMMON TO 

irritated; for this reason, they should never wear 
any thing of cotton next them, and their linen 
should be as soft and fine as may be convenient. 
When any part of the skin is so moist as to make 
the linen stick to it, a young leaf of lettuce or 
beet should be applied and changed frequently: 
when these cannot be had, a little clean suet or 
spermaceti ointment, spread on soft linen, may be 
employed for this purpose, taking care not to leave 
it long without changing it. 

These being maladies which give a great deal 
of trouble, the attendants of children afHictcd 
with them are always in a violent hurry to have 
them dried up: but a skilful, prudent, and con- 
scientious physician will not easily be persuaded 
to gratify them; and mothers should themselves 
see that nothing is neglected which may relieve 
their children's uneasiness. An extraordinary 
degree of patience is required in the persons who 
are about children in this state, as the sloiv cure 
is the only one likt ly to be safe and penman* nl. 

When properly treated, these complaints dimin- 
ish by degrees, without producing any bad effect 
on the child's general health; but if they are 
rapidly cured, that is to say, repelled from the 
surface of the skin, the disease is transferred to 
some other part, and not unfrequently some fatal 
or incurable malady is the consequence. Con- 
sumption, dropsy, asthma, epilepsy, palsy, &c. 
&c. may be brought on by the sudden cure of a 
cutaneous disease; whereas by slowly removing 
it, these dangerous effects are avoided, and in 



CHILDREN OF ALL AGES. 285 

the course of time the skin becomes clear and 
smooth. 

Children suffering under maladies of this nature 
should be warmly clad, as it is of great conse- 
quence to avoid all danger of checking the per- 
spiration; and though it be impossible they should 
wear flannel next the skin, yet the cold of winter 
may be guarded against by putting it over the 
linen, (which should be very thin,) and when the 
children go out, worsted may be put over thread 
stockings. 

There is always hopes of a cutaneous disease 
being thoroughly cured when the subject is a 
growing child; and even those which in adults 
prove inveterate, may be removed by proper 
treatment of children: but again I must repeat — 
let those who value the health and the happiness 
of their offspring beware of hurrying the cure of 
diseases, which show themselves on the surface 
of the skin only; as irremediable maladies, or 
even death, may be the consequence. 

Children are liable to many other maladies 
which do not belong peculiarly to them; but as 
the cautions I have given are sufficient to prevent 
some of these; and the others positively require 
the attendance of professional men, I do not think 
it necessary to treat farther on these subjects, in 
a work which is designed for an essay on physi- 
cal education only, and not a manual of medicine.. 



PART THE FIFTH. 



GENERAL OBSERVATIONS RESPECTING CHILDREN OF 
ALL AGES. 



CHAP. I. 

FOOD— PURIFICATION OF WATER— CHILDREN SHOULD 
NOT BE PRESSED TO EAT — IRREGULARITY OF 
APPETITE — SWEET THINGS — CHILDREN NATUR- 
ALLY GLUTTONS DO NOT REQUIRE FOOD IN 

INFLAMMATORY DISEASES. 

To preserve the existence of children, and 
promote their physical and moral welfare, con- 
stant attention is necessary to a variety of circum- 
stances, many of evident importance, others appa- 
rently trifling, but none of which can with safety 
be neglected. 

Their food, clothing, exercise, amusements, 
repose, &c. &c, also their learning and mental 
discipline of every sort, conduce to their health 
or the contrary, according as they are well or ill 
directed. 

In regard to the mode of feeding children, it is 



GENERAL OBSERVATIONS, &.C. 287 

impossible to give any precise rules, as the pow- 
ers of digestion vary in different stomachs, and 
even in the same stomach at different periods. 
Generally speaking, their food should be light, 
nourishing, and agreeable to the palate: they 
should not be forced to eat any thing they dislike; 
and the offspring of parents accustomed to the 
constant use of animal food should never be con- 
fined to a vegetable diet, unless ordered by a 
physician. The human stomach seems to be 
adapted for a variety of substances; and, there- 
fore, it would be injudicious to habituate it to one 
species of nutriment only; but sudden transitions 
should be avoided, and all the changes of diet 
which the growth of children require should be 
made by slow degrees. For those who are in 
health, it is not good to make any strict prohibitions, 
and in general it is better that their food should be 
too tonic, than not sufficiently so. A person who 
has been accustomed to children will soon distin- 
guish those who require a cooling diet; and it is 
safer, in our days, to err on the- other side than 
on this. Children in whom there is any reason to 
suspect a tendency (either natural or acquired) 
to scrofula, or any other malady of debility, 
should have the most strengthening food that their 
stomachs will support. 

It is unnecessary to mention, that great care 
should be taken to procure good bread for child- 
ren, and that all such as can be suspected of being 
made white by any unwholesome substance should 
be avoided. People are generally aware of the 



288 GENERAL OBSERVATIONS RESPECTING 

necessity of attending to this point; but it does 
not appear that the qualities of the water they 
drink is considered of equal importance. It is, 
however, perhaps of still greater; for the injury 
done by bad bread being soon discovered, in con* 
sequence of its immediate effects on the stomach 
and bowels, remedies are sought, and the cause 
quickly removed: whereas the mischief incurred 
by drinking bad water is not likely to show itself 
by any instantaneous effects (water so unwhole- 
some as to occasion sickness never being in com- 
mon use,) but slowly hurts the constitution. 

When there is any doubt respecting the salu- 
brity of water,* that which is given to children 
(or very delicate persons) should be boiled and 
left to stand till it cools, that any sediment con- 
tained in it may fall to the bottom of the vessel; 
and when it is taken off clear, it should he poured 
from one vessel into another three or four times 
(as is done in making punch) that it may imbibe 
the air, which is supposed to render it lighter for 
the stomach. Persons extremely nice in this 
respect would do well to have the water boiled in 
Mass or earthen-ware vessels, which are less 
likely to give a bad taste than those of metal. 
This mode of purifying water at least secures 
those who drink it from swallowing any live things, 
as well as from some other unwholesome sub- 
stances. 

For healthy children, there is no better drink 

* When water is known to be bad, it should \fc purified 
by distilling. 



CHILDREN OF ALL AGES. 289 

at their meals than good water. Fermented 
liquors should rather be reserved for medicinal 
purposes; and tea, or any warm diluting liquors, 
unless in case of illness should never be given to 
children: they weaken the stomach, and lay the 
foundation of many maladies. 

Except in some very extraordinary cases, one 
should never entice children to eat, by offering 
them any thing they particularly like, when they 
do not appear hungry. It is not the quantity of 
food that is swallowed, but the quantity that the 
stomach can easily digest, which nourishes and 
strengthens the body; and whatever more is ad- 
ded, rather diminishes than increases the nour- 
ishment, by giving the stomach more to do than 
it is capable of performing. Any substance that 
is digested with difficulty produces a certain 
degree of fever, which is always followed by pro- 
portionate weakness. For this reason, we may 
observe, that some children who appear strong 
and well nourished, are very small eaters; whilst 
others, who swallow large quantities of food, 
appear weak and half starved. But the fact is, 
that the former have in reality had the largest 
portion of nourishment, though they have appeared 
to take the least, because all they have eaten has 
been well digested, and the nutritive part com- 
pletely extracted; whereas those who have con- 
sumed the largest quantity of food have had but 
little nourishment, on account of their stomachs 
being able to extract nutriment from but a small 
part only of what they have eaten, and the large 
18 



290 GENERAL OBSERVATIONS RESPECTING 

portion remaining has only produced indigestion, 
fever, and consequent debility. The quantity of 
food which each child requires, can only be ascer- 
tained by observation, as well as the quality adap- 
ted to each particular stomach. 

Children require food much oftener than adults: 
and I have frequently observed in them a great 
"irregularity of appetite, according to their irreg- 
ular starts of growth. A child will sometimes 
have an inclination to eat a great deal for three 
or four months together; and then for a similar 
space of time, appear to have scarcely any appe- 
tite: but neither of these changes should ever 
occasion uneasiness to parents, if accompanied 
with no symptoms of indisposition. 

When people choose to give children sweet 
things out of meal-times, (which by the by is a 
very bad custom,) the nearer ihey approach to 
plain sugar the better. There is but one injury 
sugar can do, (and that perhaps doubtful,) which 
is to the teeth. To the stomach it can never be 
otherwise than beneficial, and the common preju- 
dice respecting its being unwholesome has origin- 
ated in the combinations with which it has been 
given. Sweet cakes, puddings, pastry, Sec. have 
often encouraged children to load their stomachs 
with more than they could digest; and the mis- 
chief resulting has been ascribed to the sugar, 
which, had it been extracted from the other sub- 
stances and given alone, would probably have 
produced beneficial, instead of injurious effects. 
I have heard of its causing an acid in the stomach, 



CHILDREN OF ALL AGES. 291 

but am inclined to think that this is rarely (if 
ever) the case; and that when such an effect has 
been observed, the sugar has been mixed with 
some greasy substance, which was the real cause 
of the complaint. I am the more particular in 
treating of this subject, because there are mothers 
who will permit then- children to devour quantities 
of meat, butter, cheese, &c. and drink beer and 
tea in abundance, who would not suffer them to 
taste a morsel of plain sugar. 

All children are more or less gluttons, (and 
perhaps they ought to be so,) but whether to such 
a degree as can injure their health, depends on 
those about them. If the faults of children are 
to be punished by making them fast, they will 
learn to consider eating as the first of privileges, 
and indulge it to excess whenever they have an 
opportunity; and if they are only to be deprived 
of certain meats which they particularly like, it 
is still worse, for they are thus taught to consider 
luxury in food as one of the greatest blessings; 
and are prepared for unnecessary misery should 
circumstances happen to prevent their enjoyment 
of it. A child should never suffer any privation 
in regard to eating by way of punishment, except 
when it is appropriate to the fault that has been 
committed: if the child has eaten too much of 
any particular thing, or has cried for it, then it is 
perfectly right to prohibit what has been the cause 
of offence: but to deprive a child of pudding or 
of pie at dinner, because he has been disobedient 
or ill-humored just after breakfast, can answer no 



292 GENERAL OBSERVATIONS RESPECTING 

purpose but to make him doubly a glutton; which 
should be carefully avoided by all those who are 
anxious to preserve the health of their children. 
Great care should be taken that the attendants 
of children, who are suffering under acute mala- 
dies, do not urge them to eat when they have no 
inclination for food, or give them improper things 
when they are beginning to recover. It is diffi- 
cult to persuade the vulgar that existence can be 
prolonged without solid food, and nothing is more 
common than to hear servants and nurses say of 
a child, in the height of an inflammatory disease, 
"Poor thing! 'he must be very weak — he has 
not eaten a morsel these five days — he can never 
hold out without some nourishment." And most 
probaby, on inquiry, one finds that the child has 
drank great quantities of diluting liquors, sweet- 
ened with sugar, which in itself contains a great 
deal of nutriment; quite as much as is suitable to 
the situation of the sick child. 



chap. ii. 

CLOTHING COVERING THE BOSOM AND ALMS 

ORNAMENTS INJURIOUS TO HEALTH BEAUTY 

TO BE ACQUIRED LIGATURES OF ALL SORTS 

BAD. 

In regard to the clothing of children, there are 
different opinions; but all persons who know any 



CHILDREN OP ALL AGES. 293 

thing of medicine must agree, that in cold weather 
they should be warmly and at the same time lightly 
clad. For this purpose there is no substance so 
proper in the winter as flannel; but the greatest 
caution should be used in changing the clothing 
after the cold is past, and it should not be done 
(especially when children are very delicate and 
have worn flannel next the skin by medical advice) 
until the weather be perfectly settled. It would 
be well to have some clothing for them less warm 
than flannel, and yet not so cool as their usual 
summer habiliments, to wear for a few days; for 
example, thick calico or some sort of cotton cloth; 
and flannel next the skin might be left off by 
putting it over the linen, and then cutting it away 
by degrees. 

Some physicians have recommended that boys 
should be put into trowsers as early as possible, 
and that girls should wear a similar dress, (which, 
with the addition of a short petticoat, seems to be 
much the fashion at present in England,) whilst 
others have given exactly the contrary advice; 
desiring that even boys should be kept as long 
as possible without the confinement of trowsers. 
These various opinions are founded on the same 
physical reasons, and the partizans of each have 
much to say in support of their different ways of 
thinking. For my own part, I confess myself to 
be against the modern custom; preferring to keep 
boys in petticoats until they are at least four years 
aid, and never to put trowsers on girls at all. 
But these arc matters of comparative indifference , 



294 GENERAL OBSERVATIONS RESPECTING 

and therefore not of sufficient consequence for 
me to explain the causes of my adhering to the 
one opinion rather than the other. What I do 
consider of great importance is, that the breasts* 
and arms of young children should be constantly 
covered, at least during cold weather, until the 
period of dentition be quite over. Children who 
have the bosom and upper part of the arms exposed 
to the cold while they are cutting teeth, are much 
more subject to coughs and inflammations of the 
lungs than those who have them covered; and no 
one can guess at how early an age a malady of 
this nature may occasion some organic defect, 
which may prove fatal by the production of pul- 
monary consumption in fifteen or twenty years 
afterwards. The exposure of the upper part of 
the arm has been supposed, by some eminent 
physicians, to have a great part in producing those 
rheumatic pains in the jaws, which destroy the 
teeth of many young people ; and there is no doubt 
that cold caught in that part is very likely to occa- 
sion the tooth-ache. I have never heard any 
reason assigned for stripping children in this im- 
prudent manner, except that " it makes them look 
pretty;" and what reasonable and affectionate 
mother would run such risks from so absurd a 
motive? But to this love of "looking pretty" 
areat sacrifices are often made; and even medical 
men have sometimes been persuaded to become 
accomplices in this folly. 

* Some medical men have considered the exposure of the 
arms and bosom as one cause of the croup. 



CHILDREN OF ALL AGES. 295 

Besides being light and warm, the clothes of 
children should always be plain. All kinds of 
ornaments and finery are injurious to their health; 
for however regardless the parents may be of the 
damage done to such useless matters, this will 
rarely be the case with the servants who are to 
mend and wash the embroidered flounces or lace 
trimmings with which the children are encum- 
bered; and therefore they will not be allowed to 
run amongst the bushes, or roll upon the grass, 
or even to skip carelessly along the smooth path- 
way, without being continually reminded of the 
respect due to their fine clothes; and whilst the 
robust courageous child will ever forget this mat- 
ter of importance, and incur daily reproaches and 
chastisements for an unworthy cause, the delicate 
and timid, impressed with the fear of spoiling its 
dress, will refrain from taking that exercise which 
the instincts of nature direct, and at the same 
time acquire an habitual veneration for the object 
of its constant care; which thus becomes an 
injury to both body and mind. No expense which 
can conduce to the health of children should ever 
be spared; but that belonging to fine clothes, 
being absolutely detrimental, might be saved with 
great advantage; and yet we frequently see pa- 
rents who would not spend money on battledoors, 
skipping-ropes, wheel-barrows, &.c. &c. lay out 
ten times the sums that these would cost on floun- 
ces and trimmings, and lace and trumpery of all 
sorts. 

Pretty children never look so well as when they 



296 GENERAL OBSERVATIONS RESPECTING 

are plainly dressed, and it is a pity to draw atten- 
tion to those who are not so, by foolish ornaments; 
especially as ugliness in children is always the 
effect of bad health, and consequent ill temper. 
A healthy, good-humored child (who has no 
strange defect or deformity) cannot be ugly; and 
indeed I have long thought that youth might be 
educated into beauty, by strict attention to their 
physical and moral welfare. 

Great care should be taken that children have 
nothing too tight on any part of the body. Un- 
necessary ligatures are hurtful both to health and 
beauty, and should therefore be prohibited. Gar- 
ters, either above or below the knees, should 
never be allowed to growing children: they are 
likely to spoil the shape of the leg, and must, in 
some degree, interrupt the circulation of the 
blood, which can never be done without more or 
less injury to the health; but the stockings may 
be fastened to some article of clothing, the point 
of support of which is on the shoulders, which 
precludes the necessity of squeezing any part of 
the body. Tight shoes occasion corns, by which 
even very young children often surfer; and such 
impediments thrown in the way of one just begin- 
ning to walk may occasion awkward movements, 
scarcely possible to be corrected during the rest 
of its life. But the worst of all pressures is what is 
frequently inflicted on the bodies of female child- 
ren, by that most detrimental of all fashions, the use 
of stays, — the origin of a thousand deformities and 
diseases, and the cause of many fatal accidents. 



CHILDREN OP ALL AGES. 297 

Were it even true that an excessively small waist 
was a necessary part of beauty, and that great 
sacrifices ought to be made for the acquisition of 
it, we should first consider how far this mode of 
squeezing the stomach and bowels is likely to 
have the desired effect; or whether it is worth 
while, for the doubtful chance of obtaining this 
end, to run the risk of producing certain ugliness, 
by crookedness and bad health. I have very good 
reason for believing that this mode of acquiring 
a slender shape does not always succeed; and, on 
the contrary, I have known many instances of 
clumsy girls, whose forms were entirely left to 
nature, who have grown up with much smaller 
waists than others who had been subjected to the 
tortures of fashion. 

I well recollect in my youth to have heard cer- 
tain individuals blamed extremely, for their very 
injudicious and careless conduct towards their 
daughters, who were doomed, by many prophetic 
voices, " to grow up as thick round the body as 
kitchen maids;" and I have afterwards seen those 
very young women, who had been so pitied for 
the cruel neglect of their parents, with more slen- 
der waists, and (what were then called) finer 
shapes than any of their neighbors, who had en- 
joyed all the advantages of being squeezed and 
tormented from their infancy. 

Beauty is by no means to be neglected; but it 
cannot exist without proportion; and if a girl be 
so formed as to have broad shoulders and broad 
hips, (as many handsome women are,) surely 



293 GENERAL OBSERVATIONS RESPECTING 

nothino; is so calculated to destroy the symmetry 
of her form as to pinch in her body until it is as 
small as her arms. Besides, let it be remembered, 
that whatever hurts the health must produce ugli- 
ness in a greater or less degree; and all persona 
who know any thing of medicine, can have but 
one opinion on the subject of tight lacing. t . 



CHAP. III. 

EVACUATIONS— EXERCISE — AMUSEMENTS WARMTH 

CHANGE OF AIR. 

No person can enjoy perfect health in whom the 
natural evacuations arc deficient. It is not how- 
ever necessary that they should be always equal: 
difference of seasons, of food, and a variety of 
other accidental causes, may produce temporary 
irregularities, which should not be subjects of 
uneasiness, and still less of medical treatment, 
unless they are accompanied with evident marks 
of indisposition. 

To dcvelope the forms of children, and give to 
every part its proportionate degree of growth and 
strength, a great deal of exercise of various sorts, 
is required; and when they are in health, nature 
^if not counteracted) will always lead them to 
continual movement. This should be encouraged 
by giving them all those toys which promote 



CHILDREN OF ALL AGES. 299 1 

activity; for the more exercise is united with 
amusement, the more it will conduce to the well 
being of body and mind. 

Mothers need not be afraid that their daughters 
should acquire masculine habits, or rough man- 
ners, because, as growing children, they are per- 
mitted to have the free use of their limbs: for 
there is no doubt that those girls are likely to be 
most graceful, as well as most healthy, who have 
been active in their infancy. It is a great 
improvement in the modern education of females, 
that they are allowed such plays as promote 
strength of body; and nothing is a greater acqui- 
sition in this respect than the shipping-rope, which 
was formerly the exclusive property of school- 
boys. Dolls are useful to girls for the purpose of 
making them acquire the necessary knowledge of 
needle-work with pleasure, (for when instruction 
can be united with amusement, it is always advan- 
tageous to the health,) but as a constant employ- 
ment in the hours of relaxation, they are too apt 
to lead to sedentary habits, which must invariably 
injure the physical welfare. 

Nothing can be more false than (what is asserted 
by several respectable male authors) that female 
children have a natural propensity to amuse them- 
selves with dolls. I never saw a robust, healthy 
girl who did not prefer those plays usually appro- 
priated tn boys; and 1 have known sickly, deli- 
cate male children as much diverted with dolls as 
females could he. The truth is, that weak child- 
ren like sedentary amusements, whilst the strong 



300 GENERAL OBSERVATIONS RESPECTING 

prefer those which are active ; and besides, girls 
are early taught that a doll is a very reputable com- 
panion, whilst boys are ridiculed if they look at 
one. These prejudices often produce effects inju- 
rious to the moral and physical welfare of child- 
ren, and therefore I think it right to point them 
out here. 

So far as air and exercise are concerned, there 
ought to be less difference made (at least till nine 
or ten years old) between the physical education 
of boys and girls than usually is. It is a great 
disadvantage to females, that at thirteen or four- 
teen years of age, they are often obliged by the 
persons about them, or induced by their own 
vanity, to relinquish those active sports which are 
necessary to the health of growing creatures, and 
which instinct would lead them to continue to a 
much later age, if art or affectation did not put a 
restraint on their movements, extremely injurious 
to both their physical and moral welfare. The 
longer those childish, sportive feelings, which lead 
to active amusements, can be preserved, the more 
healthy in body, and innocent in mind, are young 
females likely to be; and mothers would do well 
to cherish rather than suppress such propensities. 

Male children, as they grow up, should be 
inured to more violent exercise than females: they 
should be more strengthened by muscular exer- 
tions: but both sexes ought to be equally accus- 
tomed to the open air. 

Though, generally speaking, children are in- 
clined to be ever in motion, yet, there are many 



CHILDREN OF ALL AGES. 301 

who can be easily induced to remain quiet, and 
those sometimes of the most active dispositions. 
Either a very dull or a very smart child may be 
taught to sit still too much; the former for the 
pleasure of doing nothing, the latter from taking 
a strong interest in some sedentary amusement: 
but, by judicious management, without any ap- 
pearance of coercion, these injurious propensities 
may be counteracted before they have become 
habitual. 

When children are forced to walk out against 
their inclinations, and without any object of 
amusement, the discontent which depresses their 
minds, prevents the benefit of exercise to their 
bodies. For this reason, children should have 
their walks diversified, or rendered agreeable by 
the accompaniment of some of the many toys 
which induce them to take exercise; such as 
balls, skipping-ropes, kites, wheel-barrows, roll- 
ing-stones. The last-mentioned, Avhen adapted 
in weight to the strength of the individual, is an 
excellent means of opening the chest, and throw- 
ing back the shoulders; and when the child has 
the pleasure of thinking itself of use in smoothing 
the walks of a garden, for the accommodation of 
those it loves, the effects on body and mind will 
be far more beneficial than any which can result 
from the employment of dumb-bells and back- 
boards, with which so many girls have been 
obliged to pass long melancholy hours of dulness 
and discontent. 

Playing in the open air is much better for 



302 GENERAL OBSERVATIONS RESPECTING 

children than taking long walks; but those parents 
who are obliged to inhabit large towns, and have 
no gardens to their houses, should make it a rule 
to send their children to some square, or open 
place, every tolerably fine day, cither on some 
errand of amusement, or under some pretext 
which may induce them to go with pleasure. 
Every thing that makes children happy (improper 
indulgence of course excepted) conduces to make 
them healthy, raid they are never so happy 
as when in motion, in the open air. Children of 
all a^cs should be out as much as possible, that 
is to say, while it is agreeable to their feelings; 
but the persons about young infants should par- 
ticularly observe whether it gives them pleasure, 
which, when the weather is fine and they are in 
health, it never can fail to do: but it is quite 
impossible that the fresh air can afford them any 
advantage, if they be not sufficiently clothed to 
prevent them from shivering and looking so un- 
happy, as I have sometimes witnessed. All ex- 
tremes must be injurious to body and mind; and 
there is nothing to be more carefully avoided, 
in both the physical and the moral education. 
Children who are guarded against every breath 
of air, and not allowed to stir out in the warmest 
weather without being wrapped up, are equally 
liable to get cold with those who are sent out in 
nankeen dresses when the north wind blows, and 
not permitted to change their shoes when they 
have got wet. I scarcely know which is the 
worst extreme, for they both tend to debilitate, 



CHILDREN OF ALL AGES. 303 

and to produce disease. If children complain of 
cold, when they are on foot in the open air, it is 
a proof either that they are ill, or their clothes 
are not sufficiently warm for the season. When 
those of four or five years old are in perfect health 
and warmly clad, they usually delight in running 
against the wind, and playing in the frosty air; 
but such as do not, should never be forced to 
remain in the cold, which is very hurtful to sickly, 
delicate children. 

Children should not be obliged to take exer- 
cise directly after a full meal; nor should they 
be prevented, if naturally inclined to do so; they 
ought to be allowed a certain portion of time af- 
ter dinner for relaxation, which they should be 
permitted to pass either in motion or repose, ac- 
cording to their feelings. Either instinct or 
experience will soon teach them what is suitable 
in this respect ; for exercise, after eating, agrees 
perfectly with some stomachs, and not at all with 
others: therefore it is not expedient to send 
children out to take a long walk immediately 
after dinner. In general, the best time for taking 
exercise is before meals; but little children should 
not be prevented from following the impulse of 
nature, which leads the greater numher to be 
constantly in motion. 

Though the health of children is sometimes so 
invincible, and the force of habit so strong, that 
they exist and flourish in atmospheres apparently 
far from wholesome; yet whenever there is the 
Blightest symptom of debility, a change of air 



304 GENERAL OBSERVATIONS RESPECTING 

should, if possible, be contrived; and a child who 
is growing sickly or crooked whilst shut up in a 
small house, in the narrow street of a large town, 
will be more likely to recover if sent into the 
country to run about the fields, than through any 
medical or mechanical aid. 

On the first symptoms of chronic diseases in 
children who inhabit a great city, they should be 
removed into the country; and many a child will 
be sooner cured by sporting in meadows, or climb- 
ing hills, than by swallowing drugs, which are 
perhaps, not less expensive in the end, than a 
few months' lodging in some small village or farm- 
house. 

Persons of restricted incomes, especially in 
large towns, are often deterred from giving their 
children a sufficiency of air and exercise, be- 
cause they are unable to take them out them- 
selves, and fear they might be injured by being 
with common servants; but of two evils we should 
always choose the least, and the mere chance of 
learning vulgar ways, or even to tell falsehoods, 
Sic. is less to be dreaded than diseases, or weak- 
ness of constitution, which must be the conse- 
quence of confined air and a sedentary life during 
childhood; as the former is far easier to be 
remedied than the latter. Those whose occupa- 
tions prevent them from accompanying their child- 
ren in their walks, should choose the least ex- 
ceptionable person they can find to send with 
them, and trust to Providence for the rest. Once 
in fifty times a child may learn some disagreeable 



CHILDREN OF ALL AGES. 305 

or vicious habit by going out with servants; and 
forty-nine times out of fifty the health will be de- 
stroyed by staying at home. 

Parents, who have occasion to employ their 
children at an early age in any sedentary occu- 
pation, will find it greatly their interest to assign 
a certain portion of the day for exercise in the 
open air, and to see that it is so disposed of; for 
(besides the expense attendant on sickness, in a 
country where so much medicine is used as in 
England,) health is always advantageous to in- 
dustry; and a brisk, animated child will be able 
to work much quicker and better, than one op- 
pressed with the indolence which attends the 
commencement of chronic maladies. The bane- 
ful effects of a too sedentary life may be seen in 
manufactories where children are employed, 
whose sallow looks and sunk eyes the heart shud- 
ders to behold. I only allude to this evil, for the 
purpose of convincing the minds of those who 
may happen to think that the advice above given 
is unnecessary ; for it is one too painful to reflect 
on, being out of the power of such a work as this 
to remove. 



19 



306 GENERAL OBSERVATIONS RESPECTING 



CHAP. IV. 

HEAT OF ROOMS-CROOKEDNESS-ROUNDSHOUL- 

DER8-UNWH0LES0ME POSTURES— SLEEP— BED* 
NOCTURNAL TERRORS. 

The atmosphere of apartments inhabited by 
children, should be moderately heated in cold 
weather; but they should never be allowed o 
approach a lire, as there is nothing more likely to 
occasion them many troublesome maladies, such 
as tooth-ache, chilblains, inflammation of the eyes, 
fee &c They should always be encouraged to 
warm themselves by running and jumping; and 
as partial cold is very hurtful, if they complain of 
suffering much in the hands and feet (as je y 
young children sometimes do) these should be 
well "rubbed, and then covered with shoes or 
gloves which have been made hot; but on no ac- 
count should they be brought near the re 

When children are of an age to sit still at their 
Studies for any length of time, care should be 
taken that the air of the rooms they occupy on 
uch occasions be sufficiently warm, and ther 
clothes such as may be necessary to tov™*&£ 
Some children are much more sensibly , of cold 
than others; and differences should be made 
according to their years and constitutions 
"Children who have been judiciously educate 
from the beginning of their lives, and allowed to 
enjoy a sufficiency of air and exercise, are not 



CHILDREN OF ALL AGES. 307 

liable to become crooked from weakness; in 
their rapid fits of growth, however, they should 
be watched attentively, and not induced to walk 
or to stand too much at a time, lest fatigue should 
occasion awkward habits which might injure the 
form. Children are often made to sit on seats 
without backs, on purpose to prevent them from 
leaning; but this is a mistake: on the contrary, 
to keep them straight, they should rather be en- 
couraged to lean; and for this purpose should 
have chairs exactly proportioned to their size, 
made with sloping backs in such a manner, that 
when they lean against them, the chest may have 
full space to expand, which cannot be with 
straight-backed chairs. Obliging children to 
stand when they are tired, is very likely to cause 
a crookedness in the hips, as they usually stand 
on one leg to rest; when they wish it, they should 
be permitted to lie down; the well-known boards, 
which were sanctioned by fashion till they be- 
came ridiculous, are excellent things to allow 
(but not to force) children to lie down on. The 
floor however, or a hard bed or a sofa, may an- 
swer the same purpose for those who have not 
this convenience. 

If a child be observed to be growing round- 
shouldered, the cause should be examined into; 
and should it prove to arise from a careless habit 
of sitting to write, draw, Stc. a piece of stiff" 
leather, about three inches in breadth, and of a 
length sufficient to cover the shoulder-blades, may 
be applied over the shift, (or shirt,) and by hav- 



303 GENERAL OBSERVATIONS RESPECTING 

ing a case of linen, it may be fastened to the 
waiscoat with pins, in such a manner that they 
cannot hurt. This answers the purpose of re- 
minding the child not to stoop ; and in a few weeks 
it may remove the defect. If, however, it be 
ascertained that bringing forward the shoulders 
in this manner is occasioned by weakness in the 
chest, in consequence of outgrowing the strength, 
the proper remedies for debility must also be em- 
ployed, and the child persuaded to lie down when 
fatigued. 

It would be a great advantage for children to 
have the habit of using both hands equally; but 
this is not allowed, and those who are naturally 
inclined to do so are reproved for it: when, how- 
ever, by exercising the right arm more than the 
left, the shoulder on that side becomes larger than 
the other, the proper remedy is to use the left 
arm entirely, and to leave the other in repose. 

Kneeling is a very unwholesome posture, in 
which children should never be suffered to con- 
tinue long. I am particular in mentioning this, 
as I have known of some being put on their knees 
for a punishment, which is very dangerous, as 
crying and sobbing in that situation is likely to 
occasion ruptures. 

Children should be cautioned against lifting 
weights too heavy for them, or carrying each 
other, by which disagreeable accidents sometimes 
happen. 

The repose of children is not always sufficiently 
attended to. Their comfort, in respect to hours 



CHILDREN OF ALL AGES, 309 

of sleep and arrangement of their beds, is often 
too much disregarded, though perhaps of even 
more importance to their strength and growth, 
than the quality of their food. Extremes should 
be equally avoided in nourishment, clothing, and 
beds; and there is no greater mistake than sup- 
posing that children are to be made robust by 
allowing them but little covering at night. The 
sleep of a child who suffers from cold will be 
broken and unrefreshing, whilst that of one whose 
bed is too warm will be prolonged and debilitating. 
In this, the feelings of the individual should be 
consulted, (and an attentive mother will soon 
discover how far) as it must be remembered that 
children, like grown people, differ in this respect; 
and that one will require a heavy covering, when 
the lightest is almost too much for another. 

In regard to the beds of children, they should 
neither be very hard nor very soft. Feather beds 
are generally denied them, and with great pro- 
priety; but the contrary extreme of making them 
lie too hard, is by no means uncommon, though 
capable of producing equally bad consequences. 
A bed which is too soft is injurious, from being 
relaxing; but one too hard may induce a child to 
sleep in unnatural postures, and thus occasion 
crookedness; besides, when the rest is broken by 
painful sensations, it cannot bestow all the benefit 
which ought to be expected from it. 

The beet bed for a child is a thick, well-stuffed 
mattrass, (of either wool or horse-hair,) on a tight- 
drawn sacking bottom; and care should be taken 



310 GENERAL OBSERVATIONS RESPECTING 

that themattrass be re-made frequently, lest it get 
into lumps. In regard to the height of the bol- 
ster, as well as the warmth of the coverings, the 
children's own feelings should be the only rule: 
for one child, in perfect health, will desire to have 
the head high, while another, equally well, will 
prefer sleeping without any bolster ; in the same 
way that one will feel too warm with a light 
blanket, while another will suffer from the cold 
without a heavy one. While children are under 
four years old, those about them must endeavor to 
guess at their feelings: after that age, they are 
able to explain their wishes, which should always 
be attended to; for when instinct can be consulted, 
it is probably our best guide. Children who are 
not sufficiently warm at night cannot sleep quietly, 
and usually grow pale and thin; and those who 
have too much covering, become weak from unna- 
tural perspiration. All these things deserve great 
attention, as they may be remote causes of disease. 
Growing children should be allowed to sleep as 
long as they please; and if properly treated in 
other respects, there is no danger of their lying 
in bed too late. Those who take as much exer- 
cise as they ought in the clay, will require to go 
to rest early; and great care should be taken that 
their sleep be not interrupted: should it, on any 
occasion, be necessary to call them before their 
usual hour, it ought to be done in the gentlest 
manner, as there is nothing more hurtful to deli- 
cate nerves than to be suddenly awoke. Some 
children require a great deal more sleep than 



CHILDREN OF ALL AGES. 311 

others; and in this they should be allowed to fol- 
low the dictates of nature. 

Children should always be allowed to divert 
themselves, but not with any violent exercise, for 
some time before they are put to bed, that they 
may go to sleep with cheerful impressions on their 
minds. When they are extremely restless at 
night, it should be ascertained whether this pro- 
ceeds from any error in the time or the quality of 
their food, or from indisposition, that the proper 
remedies may be sought: but, as there are indi- 
viduals who, in consequence of a particular organ- 
ization of nerves, are, from the beginning to the 
end of their lives, subject to disturbed sleep, even 
when in perfect health, this should be carefully 
distinguished from the restlessness that proceeds 
from indigestion, worms, or any other morbific 
cause. What is a mark of disease in one person 
is not so in another; and, in children of this con- 
stitution, quiet sleep should be rather an object of 
attention, as an unaccustomed thing, which may 
be a symptom of some malady. Any change from 
the usual state should always be suspected as a 
sign of indisposition. 

All children should be carefully observed dur- 
ing the time of sleep; for many are subject to 
frightful dreams, against which (as being prejudi- 
cial to the health) precautions should be taken. 
When a child of any age, appears uneasy in 
sleep, it should be turned, or the head raised 
higher; or even be awakened, if nothing else be 
sufficient to break the chain of disagreeable ideas 



312 GENERAL OBSERVATIONS RESPECTING 

which interrupts its tranquillity. The constitutions 
of lively children are sometimes much injured by 
nocturnal fears; and the persons about them are 
not in general as careful as they ought to be, in 
guarding them against impressions of this nature. 
I have known children of strong imaginations 
surfer agonies of terror in dreaming of ghosts, 
witches, and devils, after having listened to sto- 
ries on those subjects, just before they were put 
to bed; and who having no soothing voice to 
console them when roused from sleep by the ex- 
cess of their fears, have suffered very unnecessary 
indispositions in consequence. People should not 
be deceived in this respect by the robust appear- 
ance of children, or be convinced that their nerves 
are strong because their minds are not cowardly; 
as it not unfrequently happens that the greatest 
sensibility of nerves is united with uncommon 
strength of body, and boldness of spirit; and that 
without particular attention, a being so constituted, 
and capable of enjoying the highest degree of 
health, may become weak and sickly, by the 
workings of a lively imagination, and consequent 
agitation of nerves. 



CHILDREN OF ALL AGES. 313 



CHAP. V. 



PAINTED TOYS INDEPENDENCE PRAISE WON- 
DERFUL CHILDREN INDOLENCE DEFORMED OR 

DISCONTENTED PERSONS SHOULD NOT EE ABOUT 
CHILDREN. 

The numerous painted toys which are made for 
children, are probably injurious to the health of 
many; and I have often suspected temporary mal- 
adies, of Avhich the causes are not evident, to be 
occasioned by these poisonous play-things. Very 
young children always put every thing into their 
mouths; and those who are older are by no means 
careful on this subject, but will readily eat bread 
or cake, with the white, and red, and green paint 
of their toys adhering to their fingers; which, 
though not in sufficient quantity to occasion an 
immediate or violent effect, must always be hurtful 
in a greater or less degree. Painted toys should 
be banished from the nursery, until children arrive 
at an age to understand, not only that their play- 
things will bo spoilt by being put into the mouth. 
or touched with wet hands; but also that the 
colored paint is poison, which by being taken into 
the stomach, may produce pain, and even death. 
At five or six years old, they are capable of know- 
ing their own interest in this respect; and, being 
aware of these dangers, they may then be left to 
their own discretion. 



314 GENERAL OBSERVATIONS RESPECTING 

Children should be made independent as soon 
as possible: too much care in preserving those 
who have passed the first weakness of infancy 
from lesser dangers, is likely to throw them into 
greater. Show them the evils they have to dread, 
and how to guard against them by their own pru- 
dence, rather than give them the habit of being 
constantly protected. Tell them to take care of 
themselves, and they will do so. Let them climb 
upon chairs, and go up and down stairs, without 
assistance as soon as possible, and they will meet 
with fewer accidents, than if they have always a 
servant to watch them; and, even if the mother's 
eye, with trembling anxiety, follows their steps, 
let them not know it. Teach them early to be 
proud of courage, and let them feel the pleasure 
of independence. Nothing conduces more to 
the well-being of children than the having a good 
opinion of themselves ; and from the cradle to 
the grave, nothing creates such an exhilaration of 
mind, as the consciousness of being able to stand 
alone. By teaching children to be proud of not 
being afraid, you give them a sense of their own 
worth, and guard them against numerous physical 
and moral ills. 

Few things are more detrimental to children 
than excessive praise; and parents who, from not 
having observed those of others, imagine their 
own to be miracles, are apt to injure them by ad- 
miring every infantine trick in presence of the 
children themselves, and forcing indifferent spec- 
tators to join in their absurd praises. In this 



CHILDREN OF ALL AGES. 315 

manner, they do infinite mischief to their offspring, 
by instilling that restless vanity, which renders 
them unhappy when they are not the chief objects 
of attention. Children should be taught to amuse 
themselves without incommoding others, and 
never to expect the notice of strangers. Let 
them always consider themselves of importance 
to their parents, as objects of present affection, 
and future esteem; but not of admiration to any 
one, much less to unconcerned visiters: and they 
will thus be spared many of those mortifications, 
which, even during the first seven years of exis- 
tence, may produce the worst effects on both 
their minds and bodies. 

Wonderful children are, by no means, common; 
nor are they to be desired. In such instances, 
what the mind gains, the body loses; and these 
unnatural infants generally grow up deformed, or 
die early. No prudent mother will ever desire 
to see her child either prematurely wise, or un- 
commonly tranquil: these are usually morbid 
symptoms, which end. in positive disease. For 
the first, there is no remedy; and distempered 
nature must take her own course: but the latter 
(especially if it be a new appearance) should be 
watched, and counteracted; not by forcing the 
child to take exercise against its will, but by 
offering every sort of amusement which can ex- 
bilarate the mind, and quicken the circulation of 
the blood. 

Females of thirteen or fourteen years of age 
are sometimes liable to that excessive indolence 



316 GENERAL OBSERVATION'S RESPECTING 

of body which is the forerunner of disease; and 
I have known mothers make it a point of obliging 
girls in this state to rise from their seats every 
moment, to go with some message, by way of coun- 
teracting this morbid propensity. But such is not 
the proper mode of curing this kind of laziness: 
on the contrary, the ill-humor excited by con- 
tinual interruptions serves only to increase the 
indisposition; and, in fact, exercise seldom pro- 
duces beneficial effects, when not occasioned by 
some agreeable motive. Amusing occupations 
should be found, which might break through the 
inclination to sit still: companions of lively dis- 
positions should be sought; dancing parties, and 
active plays might be encouraged, and country 
excursions or short journeys resorted to. Such 
method- are the besl adapted to correct that indo- 
lence, which if not occasioned by disease, at least 
tends much to produce it. 

No persons who have any great natural defect, 
or acquired deformity, should be placed about 
children, either as attendants or instructors. Ser- 
vants who squint, or have but one eye, or walk 
lame, or have particularly harsh voices, or rough 
manners, or indeed any thing that can offend the 
feelings of infants, (however great may be their 
merits in other respects,) are unfit to have the 
care of children. It is unnecessary to mention 
the impropriety of letting them be with persons 
who stutter, or have any impediment in their 
speech; but I wish, also, to caution against any 
extraordinary sort of ugliness, as the nerves of 



• CHILDREN OF ALL AGES. 317 

very young children are usually so delicate, that 
it is probable they suffer much which they cannot 
explain. 

I remember once to have heard of a poor girl, 
whose face (in consequence of her having fallen 
into the fire when a child) was disfigured in a 
frightful manner, both by distortion of features 
and unnatural color of the skin. On her going 
to serve as nursery-maid in a neighbouring gen- 
tleman's family, it was observed that every time 
an infant of nine months old looked at her, he 
began to scream violently; but this was at first 
ascribed to her being a stranger. One morning, 
however, after she had been about a fortnight 
in the house, the child, on first waking, behold- 
ing her at his bed side, was taken with a violent 
fit of convulsive crying, which lasted so long that 
it was thought necessary to send for the family 
physician; who, on inquiring into the circum- 
stances of the case, recommended that the servant 
should bo parted with. His advice was followed, 
and the child had no more fits of screaming af- 
terwards. 

Few things can be more hurtful to the health 
of children, than to see dismal countenances, and 
hear constant lamentations around them; for this 
reason parents should take especial care that the 
Bervante who are chiefly about their children be 
cheerful, free from envy and malice, and rather 
of a careless than thoughtful temper; and fathers 
and mothers who have troubles to talk over, 
should never allow their children, during infancy, 



318 GENERAL OBSERVATIONS RESPECTING 

to know any thing of the matter. The cares of the 
world always come too soon; and parents should 
prepare their children to struggle with them, by 
giving them that strength of body which so much 
conduces to fortitude of mind. This is to be done 
by keeping misfortunes out of their sight, rather 
than by studying to make disappointments for 
them, as I have sometimes heard people boast of 
doing. Prepare children for adversity, by forti- 
fying their bodies and minds; but do not give 
them habits of discontent by unnecessary displeas- 
ures. Many chronic diseases may be developed 
by whatever depresses the spirits; and in fami- 
lies where there is any reason to suspect a scrof- 
ulous taint in the blood, the greatest pains should 
be taken to keep the children constantly cheerful. 
It is generally known that strengthening and ex- 
citing food is necessary for children of this con- 
stitution; but it does not seem to be as generally 
known, that fretting is still more injurious to them 
than low diet. All those who really desire that 
their children should grow up healthy, should 
protect them as much as possible from every pain- 
ful moral sensation; should treat them with con- 
stant kindness, and procure for them every ex- 
hilarating amusement that may be within their 
reach. 



CHILDREN OF ALL AGES. 319 



CHAP. VI. 

SENSIBILITY JEALOUSY PUNISHMENTS COUR- 
AGE PEEVISHNESS. 

There is no greater error than that committed 
by persons who like to exercise what they call 
the sensibility of children, and commend them for 
proofs of feeling. When they really have that 
excessive sensibility, which ignorance of its true 
nature leads so many to admire, a prudent mo- 
ther will use every means to moderate it, as a qual- 
ity which tends to injure the health and debilitate 
the mind. It is, in reality, a defect; and there 
are few things more detrimental to the well-being 
of individuals than that extreme sensibility which, 
by some strange error in judgment, has been 
generally considered as a meritorious quality, and 
admired as a virtue, when it ought to have been 
cured as a disease. Because this moral malady 
is frequently found in persons of the most amiable 
characters, we are not to cherish it, as a necessary 
component part of a good disposition, any more 
than we should cherish the itch as a beauty, 
because those most liable to it are persons of a 
fair and delicate complexion. As in most people 
the body influences the mind, we should, in the 
work of education, consider health of body the 
first object, and every moral feeling which tends 
to disturb the physical welfare as a defect. This 



320 GENERAL OBSERVATIONS RESPECTING 

is a subject on which a great deal might be said; 
but to develope it at full length, and display all 
the dangerous consequences of a cherished and 
cultivated excess of sensibility, would lead me 
away from the object of my present work. 

Parents who sincerely desire to see their child- 
ren healthy and happy will never play upon their 
feelings, nor suffer others to do so. It is very 
common for thoughtless persons to amuse them- 
selves by exciting the jealousy of a child, without 
considering the train of evils, present and future, 
which appertain to this pernicious sentiment. 
Besides the feelings of hatred to which it infalli- 
bly leads, and which lay the foundations of moral 
depravity, there is nothing more likely to occasion 
maladies of a most dangerous nature. It de- 
ranges the stomach, bowels, nerves, liver, and 
brain; producing, according to the habits of the 
different subjects, indigestion, diarrhoea, convul- 
sions, jaundice, and various sorts of fevers. It 
also, by the general depression of spirits which 
it occasions, augments any predisposition which 
may exist to scrofula, and other diseases of de- 
bility ; and instances have been recorded, by 
eminent physicians, of children who have been 
brought to the grave by the effects of jealousy. 

This, like most other bad feelings, is entirely 
the consequence of mismanagement. The per- 
sons about children develope their faults by their 
own imprudent conduct, and then complain of 
the bad dispositions of their victims. By judi- 
cious attention, children the most inclined to 



CHILDREN OF ALL AGES. 321 

jealousy may be prevented from feeling those 
painful sensations to which they are liable; and 
in the course of time, from not being exercised, 
the baneful propensity will cease to exist. Jeal- 
ousy proceeds from weakness; and in proportion 
as the physical and moral strength increase, the 
inclination to it diminishes: but if continually ex- 
cited by the malicious or the foolish, it augments 
with years, and may perhaps at last end in that 
most detrimental of all feelings, envy, which 
poisons the sources of happiness, and forbids the 
well-being of mind and body. It is the duty of 
those who are concerned in the education of 
children, to remove every cause of jealousy far 
from them, and to watch over such as are inclin- 
ed to this defect with the most unremitting care; 
by which means it may be completely removed, 
before it has acquired any dangerous influence 
on the character. 

No expression of contempt should ever be 
made use of towards children. If it produce the 
effect desired, it degrades the child in its own 
opinion, and makes it feel that most painful and 
depressing of all sensations, shame: if it fail ot 
this effect, it fills the mind with indignation and 
resentment, and is in every way injurious to both 
the physical and moral welfare. The high-spir- 
ited child will hate the person who appears to 
despise it; while tin; timid will be awed into 
mean servility, and become contented under a 
degree of mental debasement, which is sufficient 
to destroy every virtuous feeling. Excessive 
20 



322 GENERAL OBSERVATIONS RESPECTING 

flattery may be hurtful to children, but looks of 
scorn are a thousand times more so; and vulgar 
minds are apt to use expressions of contempt, 
and exhibit disdainful airs, by way of recovering 
that level which their ignorance denies them. 
Parents should therefore be extremely particular 
respecting the manners and dispositions of those 
to whom they entrust the care of their children's 
education; for many, who would think it a dread- 
ful thing to have them beaten, will yet (perhaps 
unconsciously) subject them to treatment far 
more hurtful to body and mind, by suffering them 
to live with scornful persons. 

It is a palpable absurdity to say that all child- 
ren are to be educated without coercion, and that 
punishments are never to be resorted to. As 
well might it be asserted that health is to be pre- 
served without restraint, and that medicines should 
never be employed. Undoubtedly the less they 
arc used the better; and neither the one nor the 
other should be administered without positive 
necessity. Punishments should be, like medi- 
cines, adapted to the particular constitution and 
circumstances; if not, they may prove more in- 
jurious than beneficial; and there are some sorts 
of both which should never be employed in the 
treatment of a child. Generally speaking, the 
punishments inflicted on children should be im- 
mediate and of short duration, (as any thing 
which occasions fretting is hurtful to body and to 
mind,) and whenever it can be so contrived, they 
should appear to be the natural consequence of 



CHILDREN OF ALL AGES. 323 

the fault, or at least be so connected with it by 
some link of relationship, as to unite the two ideas 
in the child's mind. It is difficult to give exam- 
ples, without trespassing too much on the space 
allotted to other subjects; but a judicious parent 
will easily infer what the author wishes to recom- 
mend. All changes and privations which regard 
the quality or quantity of food, by way of chas- 
tisement, except they be directed to the express 
purpose of correcting some fault derived from 
that source, are to be deprecated as injurious to 
both body and mind. Such also are those which 
respect dress ; a species of punishment frequently 
exercised on female children, and which, when 
much felt, is of very bad consequence. 

All punishments which call forth the sensibility 
of children are to be employed sparingly and 
cautiously, lest they should lead to hypocrisy or 
debility. A child, who is not to have a kiss from 
mamma, whenever it has been disobedient or 
cross, will perhaps either fret extremely, or to- 
tally disregard it; and a cunning child will soon 
learn to feign great uneasiness about a species of 
chastisement, which it is unnatural should make 
any very durable impression. 

No faults of children should ever be punished 
in such a way as to make them think themselves 
objects of contempt. Teach a being to despise 
himself, and you prepare his mind for the recep- 
tion of every vice and every baseness. Self- 
respect is necessary to the existence of virtue, 
and without it, there can be no hope of establish- 
ing either physical or moral welfare. 



324 GENERAL OBSERVATIONS RESPECTING 

The injudicious way in which young children 
are usually treated, makes them more unreason- 
able than they would otherwise be, and often 
occasions them to cry for things which they can- 
not have. It should be established as a general 
rule in all nurseries, that the children are to have 
immediately whatever they ask for with good- 
humor and civility, if it be possible to give it to 
them: what they cannot have, should be refused, 
mildly but positively; and on no account should 
they ever obtain any thing by crying for it. They 
would soon learn by this, that it was their interest 
to be good humored; and thus would be removed 
a great source of that peevishness and discontent 
which is so detrimental to the health of body and 
mind in the first years of childhood. 

At two or three years old it sometimes happens 
that children of great vivacity will cry and scream 
without well knowing why, for a length of time to- 
gether. jVo doubt this proceeds from some error in 
the treatment of them ; but let the origin be what it 
may, it is necessary to seek a remedy, and (when 
perfectly secure that it proceeded from no mal- 
ady,*) I have usually found the best to be threo 
or four smart slaps with the open hand. The 
child's attention is immediately attracted by this 
new misfortune; it screams perhaps a little more 
loudly for the moment, but as soon as the smarting 

•This is of great consequence to ascertain, as children 
troubled with the long round worm (lumbricus) are verjr 
subject to violent fits of screaming, which might lead to 
vexatious mistakes. 



CHILDREN OF ALL AGES. 325 

ceases, the crying is at an end. This is, however, 
a remedy which can only be administered with 
advantage by a parent, or some person of high 
authority in the family, and should no more be 
left in the hands of nurses or of servants than any 
other medicine: besides, it must be observed that 
it does not agree with all dispositions, and when 
it does not immediately produce the beneficial 
effect above mentioned, should not be persisted 
in. Punishments should always be employed to 
cure, not to irritate; and those which are found 
to exasperate rather than to correct, should at 
once be relinquished. And here I should wish to 
impress in the strongest manner the danger of 
indiscriminate blows. There is but one part of 
the body on which a child may be struck with 
perfect safety; and I am afraid since birch-rods 
have gone out of fashion, children have been more 
subject to blows in other places. I am no advo- 
cate for birch-rods, or any other instrument for 
inflicting pain, but there are cases in which I know 
that two or three slaps on the part formerly sub- 
mitted to the government of the rod, may have a 
very good effect on children under four years old. 
But nothing should ever induce any one to give 
the slightest blow about the head or neck: what 
i> called a box on the ear may be the occasion of 
incurable deafness, and an unlucky slap on the 
back of the neck may cause a serious injury to 
the spinal marrow. Blows on the head from harsh 
instructors, have been suspected to produce water 
on the bruin; and the mode in which some people 



326 GENERAL OBSERVATIONS RESPECTING 

gratify their anger towards children, by violently 
shaking them, might also lead to serious conse- 
quences. 

Locking up children in dark rooms, or inflicting 
any other punishment which may strongly affect 
their nerves, should be prohibited. Terror is a 
sensation against which they should be protected 
with the greatest care: the injuries done by fear, 
to the physical and moral health, are incalculable; 
and a child who is frequently exposed to such 
debilitating feelings, can never become so robust 
in body, or so virtuous in mind, as he might oth- 
erwise have been. Courage is the first quality 
that should be cultivated in children ; it is in every 
way beneficial to them, and in passive courage 
they may be exercised at a very early age. They 
should always be commended highly for bearing 
pain well; and when violently affected by a tri- 
fling hurt, means should be sought to draw off 
their attention from it, and make them ashamed 
of their cowardice. I remember once to have 
seen a child (under three years old,) who was 
crying bitterly for the scratch of a pin, instantly 
suppress his tears on seeing his mother give her- 
self a similar scratch. He looked up in her face, 
shewed great surprise at seeing her smile, exam- 
ined the hurt on his own arm, then that on hers, 
(which was the worst of the two,) and ceased his 
complaints. 

There is no quality more in the power of edu- 
cation, and none more beneficial to ourselves and 
others, than courage, which by no means depends 



CHILDREN OF ALL AGES. 327 

so much on the nerves as those imagine who sup- 
pose, that all women have a right to be cowards. 
This opinion is extremely injurious to the health 
of young girls, who would often try to conquer 
their fears, if they were not taught to believe it a 
thing impossible, and that they even appear more 
amiable as helpless than as independent beings. 
Children should never be allowed to continue 
whining and fretting, as there is nothing worse 
for the health than the prolonged sensation of 
discontent; but it is not always by soothing and 
caressing that this is to be remedied. Something 
which excites a stronger feeling may be necessary, 
and a sharp reproof, a threatened punishment, an 
additional task, or a disagreeable* medicine, is 
sometimes required. Habits of discontent devel- 
ope chronic diseases, and a peevish child has 
little chance of growing up healthy or happy. 
The causes of peevishness should be attentively 
studied, on its first appearance, and the appropriate 
remedies, moral and physical, immediately em- 
ployed for the cure of it. 

'•'See page 171. « 



328 GENERAL OBSERVATIONS RESPECTING 



CHAP. VII. 

FRAISE FORGIVENESS RELIGION LEARNING 

ACCOMPLISHMENTS. 

Great caution is necessary in bestowing praise 
on moral qualities, and a child should seldom if 
ever, be commended for any act which is the spon- 
taneous effect of a naturally good disposition. 
Nothing should be applauded which does not 
require exertion ; but efforts of industry, instances 
of self-denial, command of temper, correction of 
faults, should be applauded. It is dangerous to 
commend children for proofs of affection, sympa- 
thy, or benevolence: let it suffice for them to 
perceive that they are loved the bettor for those 
qualities; but if they are applauded for them, 
they may learn to place too high a value on mere 
propensities to do good, and content themselves 
without the principles of virtue; they may learn 
to admire show, and affect prettincss instead of 
acquiring worth. How many women are thero 
who, had they been prudently educated, might 
have been just and estimable, yet have become 
weak and useless from having in their early years 
heard their great tenderness and excessive sensi- 
bility (the effect, perhaps of physical infirmity) 
cried up as virtues of the first magnitude! and 
how many men have turned out spendthrifts, be- 
cause they were admired as children, for their great 
generosity in giving away money, of which they 



CHILDREN OF ALL AGES. 329 

did not yet know the value! If praise and blame 
were more judiciously bestowed, and the exciting 
causes more accurately weighed than they usually 
are, they would have far better effects in the 
physical and moral education of children. 

Persons who are fond of forgiving children, 
should be careful to make their punishments con- 
ditional, that they may leave themselves some 
fair pretext tor change. The condemnation being 
once absolutely pronounced, by remitting the pun- 
ishment, they confess themselves unjust, either in 
their first or their last act, a thing which should 
never be allowed in any kind of education. The 
punishment having been decreed, should be inev- 
itable; for the hope of ultimate pardon often 
encourages errors; and (what more concerns the 
subject of this work) the suspense and disappoint- 
ments which uncertainty occasions, are extremely 
detrimental to the health of children. 

The first principles of religion conduce much 
to the physical welfare of children, and should be 
taught them as soon as possible. Those who are 
not accustomed to observe them, can scarcely 
believe how curly children arc capable of under- 
standing and rejoicing in the notion of a Supreme 
Being, on whose protection they rely; and whom 
they feel satisfaction in endeavoring to please. 
But it is of tii" ii :n tsri consequence to the health 
of children, that all gloomy and terrific ideas 
connected with tin.-; subject should be concealed 
from them; for as much as may be the benefit 
derived from the consoling thought of a protecting 



330 GENERAL OBSERVATIONS RESPECTING 

Providence, so much injury may they receive from 
the fear of an evil spirit, wandering about on the 
face of the earth seeking whom he may devour. 
In truth, the more that every thing can be repre- 
sented under a cheerful aspect to children, the 
better for their health of body and mind. 

It is extremely difficult to determine, with re- 
spect to the physical welfare, at what time a child 
ought first to learn to read; and, indeed, it should 
depend entirely on the constitution and character 
of the individual. Lively, healthy children are 
more likely to find occupation for themselves, 
and, therefore, have less necessity for being taught 
early than those who are indolent and inclined to 
chronic diseases; yet these latter are more in- 
jured by coercion of any kind, and all children 
cannot be taught in play. The moment a child of 
any age or disposition appears to be at a loss for 
employment, it should begin to learn; and those of 
delicate constitutions should, perhaps, be taught 
earlier, that they may advance by slow degrees. 
Generally speaking, when children do not appear 
at a loss for something to do, it is by no means 
necessary that they should begin to learn till after 
four years old; and with proper management, 
during the first year or two, it ought not to occa- 
sion them any uneasiness. Strength of body 
should be the first object of our care, and what- 
ever can interfere with that should be avoided: 
but the instruction of children, if conducted with 
discretion, will increase rather than diminish the 
physical welfare, as habits of regularity and the 



CHILDREN OF ALL ,AGES. 331 

alternation of labor and amusement must ever 
promote health and happines. 

In summer-time children should be encouraged 
to rise early, by allowing them to begin the day 
with exercise in the open air; indeed at all times 
of the year, they should get up with the prospect 
of some agreeable exercise for the first quarter 
of an hour; and, for this purpose, some large 
hall or unfurnished room should be allotted by 
those who can afford it, for their children to play 
in; where, in bad weather, they may divert them- 
selves with skipping-ropes, battledoors and shut- 
tlecocks, and other active sports. A child who 
gets up, in a cold morning, with the dreary pros- 
pect of sitting down to study immediately, will not 
leave his bed with the same cheerful alacrity as 
one who knows he can warm himself by play, for 
a quarter of an hour, before he goes to his books. 
It is very unwholesome for children to study in a 
morning by candle-light, and likely to occasion 
inflammations of the eyes, especially if the time 
of sleep has not been so long as is necessary for 
those who are still growing. 

Moral virtue and physical welfare are so nearly 
connected, that they must unavoidably be culti- 
vated together; but the improvement of mere 
talents should always be considered as a secondary 
pursuit, by those who esteem health of body and 
purity of mind (he most important objects of edu- 
cation. Female children particularly, are often 
made very unhappy for the purpose of acquiring 
what are called accomplishments; and one of the 



332 GENERAL OBSERVATIONS RESPECTING 

most valuable of social qualities, a cheerful tem- 
per, is sacrificed to the doubtful chance of being 
able to excel in some fine unnecessary needle- 
work, or to display astonishing skill on some use- 
less instrument of music. The utmost success in 
these, (even when cultivated for the laudable 
purpose of obtaining a livelihood,) is but a poor 
compensation for the loss of good health, or good 
temper: and if the physical and moral well-being 
of children be counted the most desirable attain- 
ment, I have no hesitation in asserting, that what- 
ever makes them miserable in the acquirement of 
it, is better not learnt at all. 

At the same time that I appear averse to the 
Cultivation of accomplishments, (the general mean- 
ing of which comprehensive term is a smattering 
of ornamental, but useless, arts,) it is only when 
they are held in more than their due estimation; 
on the contrary, considered as a means of filling 
up the time of children, and giving them habits 
of regular employment, it must be acknowledged 
that they conduce much to their physical and 
moral welfare. The mechanical exercise of the 
hands on the piano-forte may be taught as early 
as four or five years old with great advantage: 
the position is not unwholesome, the variety of 
sounds amuses the imagination, and the exercise 
of three of the senses at once assists the memo- 
ry of children: so that if the teacher be gentle 
and judicious, great progress may be made in 
that art, at a very early age, without injury to 
the health or the temper. 



CHILDREN OF ALL AGES. 333 

It is a great and most hurtful error to oblige 
children to devote those hours to study, which 
ought to be employed in exercise in the open air; 
and so far from confining them against their will, 
even those who desire to continue beyond the 
regular hours appointed for labor, should not be 
permitted. Nothing should interfere with air and 
exercise; and it will generally be found that the 
child whose body is strengthened by a proper 
physical education, although less time be daily 
given up to study, will, at the end of the year, 
have done more than one whose constitution has 
been rendered weak by too much confinement 
and application, and whose studies have been, 
consequently, interrupted by frequent indispo- 
sitions. 

In writing, drawing, or doing any kind of 
needle-work, constant attention should be paid to 
prevent children from sitting crooked, leaning 
the chest against a table, or acquiring any other 
awkward positions equally detrimental to health 
and beauty. 

The greatest care should be taken to preven 
children from learning those vicious and destruc- 
tive habits, which are, sometimes, unfortunately 
acquired by indiscriminate and careless inter- 
course with strangers. For this reason, a pru- 
dent mother will not allow her children to be with 
others whom she does not perfectly know, Avithout 
the presence of some grown person, who can be 
relied on to pay them strict attention; as the 
most innocent child might learn, during the mo- 



334 GENERAL OBSERVATIONS RESPECTING 

mentary absence of an attendant, what would be 
of the utmost injury for years. Indeed, when 
children are at play together, the more they can 
be in exercise in the open air, the greater benefit 
and the less harm will they derive from the num- 
ber and variety of their companions. It is very 
probable that all unnatural and unwholesome 
practices are the consequence of errors in the 
physical education, the chief of which is not per- 
mitting children to enjoy a sufficiency of fresh air 
and active amusement. 



CHAP. VIII. 

PHYSICIANS — MEDICINES — TREATMENT OF CIIII.D- 
ni:N WHEN ILL — CONCLUSION. 

When a physician is called to a sick child, it 
should be with a full reliance on his skill, and a 
determination to follow his advice. Be sure that 
he is a skilful man before you consult him, then 
ftive him all the information in your power, on the 
subject of the malady which has required his 
presence, and afterwards obey his orders accu- 
rately. If, however, he should happen to pre- 
scribe any thing that the child particularly dis- 
likes, or which has before disagreed with it, ex- 
plain all this, and a judicious practitioner will 
either substitute another mode of treatment equally 
applicable, or tell you if the case be such that no 



CHILDREN OF ALL AGES. 335 

other than the medicines already directed can 
benefit. If it should happen, on any occasion, 
that unexpected resistance on the part of the 
child may have prevented you from doing exactly 
as the physician has ordered, fail not to inform 
him at his next visit: a man of good sense will 
hardly blame you for not having used violence 
with a sick child; but you may do the greatest 
injury by deceiving the medical attendant, in 
letting him suppose that medicine has been taken 
when it has not : still worse is it to give the pre- 
scriptions of old nurses, or of quacks, privately, 
when a professional man is consulted: these are 
sometimes perfectly harmless, and if the permis- 
sion of the physician can be obtained, may be 
given for the gratification of relations; but, they 
are often composed of active substances, whose 
administration is by no means a matter of indif- 
ference. Above all things, no patent medicine 
should ever be given to a child, without the spe- 
cial leave of a medical man. 

There is nothing I am more anxious to impress 
on the minds of mothers, than the injury done to 
children by giving them too many and too strong 
medicines. It is not uncommon to hear ignorant 
people blame the doctor for not ordering, what 
they suppose a sufficient quantity of physic; but 
this accusation, especially in regard to young 
patients, should always give a favorable impres- 
sion of a physician: if he be a man of no eminence, 
he at least shows good sense in not being persua- 
ded to give much medicine; and if he be a man 



336 GENERAL OBSERVATIONS RESPECTING 

of established reputation, it is most probable that 
whatever plan he pursues, is that best adapted to 
the case before him. 

Although I positively assert, that children 
ought to have much less medicine than is usually 
given to them in this country, I must point out a 
contrary error of fatal tendency, which some- 
times occurs. There are extraordinary cases of 
inflammatory disease, which require the employ- 
ment of remedies that appear too violent for the 
state of the sick person: but, when a physician 
deserving of coulidence is called to a child in an 
acute malady, his orders should be obeyed with 
the most scrupulous attention; and no fear of 
weakening the patient should cause the omission 
of any purgative, emetic, or bleeding which he 
prescribes. It frequently happens, that where 
there is an appearance of the greatest debility, 
an abundant evacuation will relieve it; and what 
ignorant by-standers have supposed would be suf- 
ficient to put an end to a being in so weak a 
state, has been ordered by the judicious physi- 
cian on purpose to remove this very appearance 
of weakness. A child lias been seen to gain 
strength immediately on the administration of 
some active remedy, which the attendants were 
convinced must occasion instant death. 

There are persons sometimes found so unrea- 
sonable as to blame the physician when the patient 
dies. No doubt the most skilful of men are like- 
ly to err; but not once in a hundred times does it 
occur to a man of learning and experience to mis- 



CHILDREN OF ALL AGES. 337 

take the nature of a disease so far as to order im- 
proper medicines; and, if the malady should have 
been of such a very extraordinary and occult na- 
ture as to have deceived a man of eminence in 
his profession, it is not likely that persons without 
knowledge should have discovered the truth. 
There is no science less understood by the mul- 
titude than that of medicine, and yet every one 
thinks he has a right to judge of the conduct of 
a medical man. I only mention this for the pur- 
pose of cautioning mothers not to be led astray 
by the assertions of the unlearned, either in 
regard to giving medicines unknown to the phy- 
sician, disobeying his orders, or blaming him for 
events beyond his power to control. 

In the cure of all maladies, great attention 
should be paid to the particular constitution of the 
child, as the same treatment is not equally adapted 
to all; and nothing is more likely to lead into 
dangerous errors, than for ignorant persons to 
medicate one child in the manner they have heard 
of another being cured by some eminent physi- 
cian; when perhaps the same physician, if con- 
sulted, would employ a quite contrary method, 
required by a total difference of circumstances, 
not evident to persons of less discrimination. 

It is to be observed, in regard to all medicinal 
substances, that they do not agree equally well 
with every constitution, nor produce always the 
same effects: bul on this subject the judgment of 
those about children must be exercised, as it is 
impossible to give any but general directions. 
21 



338 GENERAL OBSERVATIONS RESPECTING 

One rule always to be observed, is, that no strong 
dose of any remedy should ever be tried without 
the authority of a medical man: in small quanti- 
ties, all those prescribed in this work may be 
employed without danger; and the effects will 
show whether the dose can be increased with hope 
of advantage. 

I have sometimes known physicians of the first 
eminence order remedies for children, which it 
was not possible to persuade them to take; and, 
in certain cases, the being forced to swallow a 
disagreeable medicine may be as dangerous to an 
infant as the malady for which it has been pre- 
scribed. On such an occasion, it would be right 
to inform the physician of this circumstance, and 
inquire from him whether, at all risks, the remedy 
must be administered, for sometimes this cannot 
be dispensed with; as for instance, with respect 
to bark, in certain maladies, when the life of the 
patient depends on taking a large quantity of that 
particular medicine. In lesser matters, and es- 
pecially on unforeseen occasions a mother must 
sometimes use her own judgment; and when it is 
possible to save a sick child from the pain of cry- 
ing and agitating its nerves, it is always better to 
do so; this may frequently be effected by chang- 
ing the form of the medicine prescribed, which a 
judicious physician will always be willing to do, 
if it be in his power. 

I recollect an instance of a child, who was suf- 
fering under a severe attack of inflammation in 
the chest, being ordered sinapisms to the feet. 



CHILDREN OF ALL AGES. 339 

This child was about fifteen months old and of a 
very quick temper; the sinapisms where no sooner 
applied than they were kicked off; fomentations 
of the same nature were then attempted, but with 
as little success. At length the mother, taking the 
child out of the bed, placed it on her knees, and 
(as if in play) contrived to get its feet into a 
sinapized bath, in which she continued to rub them 
with her hand for twenty minutes; this produced 
the good effect expected from the sinapisms, and 
occasioned the child no agitation or displeasure. 

Children are frequently induced to make too 
much of their maladies, with the hope of indul- 
gence and relaxation from their studies; or to 
conceal them, through fear of confinement and 
medicine; and it requires great judgment and 
moderation to treat them properly, when such is 
the case. While they are very young, it is much 
safer that they should be inclined to exaggerate 
their indispositions, and as they grow older, the 
persons about them must observe that they do not 
hurt their health by refraining from expressing 
what they feel. A child should never be accused 
of pretending to be ill: if the reproach be unjust, 
the vexation of a false accusation may augment 
the child's disease; and if it be just, a punishment 
ought to follow, which would be better avoided, 
liut when a child assumes an appearance of mal- 
ady where there: is none, or greater than that 
which docs exist, it is very easy to render the 
circumstances attendant on the supposed or exag- 
gerated indisposition so disagreeable, that they 



340 GENERA OBSERVATIONS RESPECTING 

may prevent a eontinuar.ee or repetition of the 

S. IR a" c— ° f real iUneSS ' J Sh °T-Z 

commend, as part of the enre, that the medicines 

be as little nauseous, and the confinement as little 

Lome as possible: whereas if there be any 



"tolus eltiat a child affects to be i 
Medical substances (of uo active operation but) 
Zy offensive to the taste, such as a htt.e pow- 
dered rhubarb in water, or a small glass of infu- 



In of wormwood, chamomile, or quassia, may 
b „ administered without any attempt to disguise 
.heir disagreeable quantities; and at the same time 
Ac child may be kept in bed with little light, and 
no company. I will answer for it, that this mode 
o. 3d" — d indisposition will speedily 
^ all wish to appear i.l, and preveut_.be 

necessity of resorting to harsher measures. The 
n „ el t care should however be taken to *£■ 
: u ish the assumed illness of a cunning child from 
Ore languor ami uneasiness of one who is on he 
brfirkoT chronic diseases, snch as scrofula, hy- 
drocephalus, Ike. or suffering under that irregular 
fever which sometimes proceeds from extremely 
rapid growth; as it is a far less dangerous error 
o treat a feigned malady as a real one, than to 
mistake the Indisposition of a delicate child for 

m ctre'should be taken that the attendants of 
ohildren do not find means to persuade them (tor 
the purpose of sparing themselves some slight 
"convenience, that it is a great merit to concea 
and disregard indispositions, as snch a notion has 



CHILDREX OF ALL AGES. 341 

sometimes been followed by dangerous conse- 
quences, in rendering maladies severe wbich might 
have been removed by a little attention in the 
beginning. 

It would be a great advantage if the minds of 
youth could be early impressed with the value of 
good health, as one of the chief ingredients of 
happiness. Cheerfulness, activity, usefulness, 
depend much on the possession of physical pros- 
perity; a blessing which many lose by not being 
aware of the means of preserving it, and which 
few would disregard, if it were represented to 
them in the important light it deserves. 



A firm conviction that the most delicate infants 
may grow up healthy, with constant and judicious 
attention, while the most robust may become sickly 
through either neglect or ill-adapted care; and a 
strong belief, that if all children had the benefits 
of sufficient air, exercise, and amusement, good 
moral discipline, habits of moderation, and regular 
occupations, great care, but little medicine in 
slight maladies, and strict obedience to skilful 
physicians in severe diseases, the happiness of 
mankind would be much augmented; have led to 
the composition of this work, in which it is hoped 
will be found such instruction and advice as may 
enable young mothers to direct the j>hy$ical education 
of their children with success. 



APPENDIX. 



The following medicines should always be kept in a 
house where there are children, and ought to be pro- 
cured from some eminent chymist and druggist, as 
much depends upon their being of the best quality. 

Rhubarb. — This root is one of the most useful rem- 
edies in the diseases of children. It should be kept in 
pieces, for the purpose of preparing the infusion, &c. 
and in powder for immediate use. In the former state 
(when good) it is compact, rather heavy, and yellow 
on the outside ; but when broken, is streaked with red, 
white and yellow. The brown and spongy is bad. 
The powder is also yellow, and has a strong smell and 
taste: it should be kept in a bottle well corked. The 
quantity oftliis lust, for a purge, is from two to four grains 
for an infant under two months old ;Jive or six for a child 
of u ycir old : eight or ten for a child of five years old ; 
and one of twelve may take fifteen or twenty.* When 
mixed with magnesia, less is required. A child, 
who h;i< b great disgust to the powder, may take the 
infusion; which can be prepared either by pouring 

" These quantities (its well as those of the other medicines) 
BjMUt be varied as experience shows to be necessary for 
different constitutions. 



344 APPENDIX. 

three ounces of boiling water on thirty grains of pow- 
dered rhubarb, and after letting it stand in a covered 
vessel two hours, straining and sweetening it; or by 
putting a drachm of the root, a little pounded, into two 
ounces of cold water, for four-and-twenty hours before 
it be strained and sweetened. To infants, either of 
these preparations may be given by tea-spoonsful ; but 
a child of seven years old may take a dessert-spoonful, 
and a child of twelve a table-spoonful : sometimes 
double that quantity is necessary. 

The syrup of Endive recommended in this book, is 
prepared in the following manner: six drachms of 
endive roots and two of the herb, one ounce of rhubarb 
pounded, and seven grains of alkaline salt of tartar, 
must boil in a quart of water down to three half pints; 
then strain with strong pressure, add eighteen ounces 
of fine sugar, and make a syrup in the usual manner.* 
If this be found troublesome, a syrup of rhubarb, to be 
used in place of it, may be prepared by taking half an 
ounce of the root pounded, two scruples and eight 
grains of cinnamon, the same quantity of carbonate of 
soda, and four ounces of boiling water: this must di- 
gest for six hours, be strained, and have eight ounce3 
of fine sugar dissolved in it ; and then be strained 
again. Either of these syrups may be given to little 
infants by tea-spoonsful, and to children of four or 
five years old, by table-spoonsful ; after that age, pow- 
dered rhubarb must be mixed with them, or they will 
have little effect. The spirituous tincture of rhubarb 
may be given in doses of from three drops to half a 
tea-spoonful, in any convenient liquid, as a strengthen- 
ing medicine for the stomach and bowels, but never as 
a purge, to children. 

* The syrup of endive so much used for young children 
in Italy is made in this manner. 






APPENDIX. 345 

Magnesia is one of the best remedies for those acid- 
ities to which young children are so subject, and a very- 
safe one, as it carries off the offensive matter by the 
bowels. This powder should be perfectly white, 
smooth, and free from all taste and smell. It may be 
given to little infants (either alone or with rhubarb) in 
doses of from three to ten grains, and in much larger 
quantities to children advanced in age. It should be 
kept in a bottle well corked. 

Calomel is the only preparation of mercury that 
may be given to a child without the orders of a physi- 
cian ; and the person from whom it is bought should 
be asked for the mildest preparation. This powder may 
be given, at first, in the quantity of half a grain for 
every year of the child's age, (so that a child of six years 
old would take three grains,) and may be increased to 
a whole grain, if the effect be not found sufficient, until 
after eight years old, wheu the dose must not be aug- 
mented without the advice of a medical man. If too 
little of a medicine have been given, it is easy to repeat 
it : but the mischief done by giving too much at once, 
is difficult to remedy. Acids and vegetable food should 
be prohibited for some hours before calomel be admin- 
istered ; and, also, for the whole <lay alter it has been 
given at night, lest it should occasion pains in the stom- 
ach or bowels ; and, for the same reason, cold drink 
is better avoided till afterit has worked off Care should 
be. taken that a child be not exposed to cold or damp 
after taking this m< dicine. It is best to keep calomel 
in a bottle. 

Castob-oil, when really good, has little taste or 
smell, is of a light color, and thicker than salad oil; 
and, to prevenl it from growing rancid, it should be 
kept in a cool, dark place, in a bottle well corked and 



346 APPENDIX. 

covered, so as to prevent all possibility of the air get- 
ting to it ; but, even with these precautions, it is better 
not to keep it long. It is an excellent remedy for 
many complaints, as it usually operates quicker than 
other mild purgatives. A child of a year old may 
take one small tea-spoonful ; one of three years old may 
take two; one of six, half a table-spoonful, and a child 
of ten years old may take a whole table spoonful ; the 
spoon being more or less full according to the age and 
the facility of being purged. This medicine may be 
given in various ways, but it is less nauseous in warm 
liquids than in cold, as heat diminishes the thickness 
of the oil. Broth, lemonade, or mint-water may be 
used, according to the different tastes of the sick ; and 
it is better to pour the oil on the top of the other liquid , 
than to attempt mixing them together. Little children 
may be induced to take castor-oil, by mixing it either 
with lemon juice, or with the yolk of an egg. The 
lemon juice should first have a sufficient quantity of 
sugar dissolved in it, and then be put into a phial with 
the oil, of which it should be nearly double the quan- 
tity ; these should be well mixed by shaking, and swal- 
lowed before they begin to separate. If given with 
yolk of egg, the latter must be rather more in quantity 
than the oil, which is to be beat up with it, and then 
warm, sweet, lemon-peel tea must be mixed with it, in 
the quantity of a table-spoonful to every tea-spoonful 
of the oil, which forms an emulsion not at all disagree- 
able.* 

Oil of sweet almonds is in general to be prefer- 
red to castor-oil for little infants, and may be given in 
larger quantities, twice or three times as much : it is 

*The easiest way to administer castor-oil is to beat it up 
in a small quantity of warm milk. Am. Ed. 



APPENDIX. 347 

too mild a purgative for children past three years old, 
except in particular cases. It easily grows rancid, and 
should be kept with great care, in the same manner 
directed for the foregoing, if it cannot be had fresh made 
at the moment it is wanted, which would be always 
preferable. 

N. B. In case of sudden attack of cholic, good sa- 
lad oil may be used in the place of either castor-oil or 
almond oil ; and is to be preferred to them when they 
are not of the best quality. The quantity necessary 
is rather more than double that of castor-oil. 

Ipecacuanha is, next to rhubarb, the most useful 
medicine for children. There is no occasion to keep 
any preparation of it except the powder ; (which should 
be preserved in a well-corked bottle.) It is not ex- 
tremely nauseous, and may be given to young child- 
ren in any sweet drink. It is a mild and safe emetic, 
of which two or three grains may be given to children 
under a year old ; and from five to fifteen, according to 
the age and facility of vomiting, may suffice for those 
between two and thirteen. Sometimes much larger 
doses are required to produce this effect. In modified 
doses, ipecacuanha produces perspiration ; and is ben- 
eficial in many diseases, without acting as a vomit. 

Kermes mineral is a powerful and valuable medi- 
cine in hooping-cough and catarrhs, and is frequently 
ordered by physicians for cutaneous diseases. It is a 
dark red powder, which should never be got from any 
but a very good cliymist. Being a substance of very 
unequal strength, it should always be tried on some 
adult before it is given to an infant ; as half a grain of 
one preparation of it will have as much ('fleet as two 
of another. It should be given at first in very small 
doses: the eighth part of a grain to a child of seven 



348 APPENDIX. 

years old, two or three times a day, will be sufficient 
until the effect be observed. Both this and calomel 
are very dangerous if given in too large quantities ; 
and kermes mineral is a violent emetic. This medi- 
cine will remain good for years, if preserved from air, 
light, and damp. 

Oxymel of squills, an excellent remedy for ca- 
tarrhs and many other complaints, may be given in 
doses of from a quarter of a tea-spoonful to a whole lea- 
spoonful, several times a day, to young children ; and 
in larger quantities, according to the age and malady 
for which it is prescribed. It occasions vomiting when 
in a sufficient dose, but is seldom given with that in- 
tention except to little infants. 

Gum arabic should not be bought in powder, but 
kept in lumps, to be pounded when it is wanted to be 
dissolved in any liquid, or to prepare the mucilage, 
which may be made by pouring gradually three ounce* 
of boiling water on two ounces of the gum reduced to 
powder, and stirring it till well mixed. 

Syrup of white poppies is a mild opiate for young 
children, and may he given in doses of from a tea to a 
table-spoonful, according to the age and circumstances. 
When mixed with the two foregoing for a cough, they 
should he all in equal quantities. 

Nitre is a white pure salt, which any one, who has 
once tasted it good, cannot be mistaken in. It may be 
given in the quantity of three grains to children of two 
years old, and from that to ten as they advance in age ; 
and may be dissolved in water, or any other insipid 
drink. With warm milk and water in the quantity of 
a tea-spoonful to six table-spoonsful, it is good to hold in 



APPENDIX. 349 

the mouth for the tooth-ache of children ; and with 
cold water, as an application for bruises. 

Camphor should he kept (for the purpose of prepar- 
ing the julap) in a bottle, with a glass stopper. To 
make the camphorated spirit, one ounce of camphor 
may be dissolved in three ounces of rectified spirit of 
wine. The camphor julap is prepared as follows : — 
one drachm of camphor must be well rubbed in a glass 
mortar, first with ten drops of rectified sjairit of wine, 
and then with half an ounce of white sugar, on which 
must be poured, by degrees, fifteen ounces of boiling 
water; ami when well mixed, it should be put into a 
bottle and corked. This medicine may be given in the 
quantity of one or two table-spoonsful, three or four 
times a day, to children from one to four years old, in 
those maladies which require it: the quantity to be 
increased for those who are older. Camphorated spirit 
with laudanum ; a table-spoonful of the former to a 
tea-spoonful of the latter is a good external application 
for tb" stomach and bowels, in case of great pain or 
obstinate vomiting. 

Spirit of hartshorn should be kept in a bottle, 
with a glass Btopper, which ought never to be left long 
open. From two to four drops may be given, in any 
watery liquid, to children under five years old, and 
inn-eased in proportion to their age, to eight or ten 
drops. Volatile liniment may be made, by shaking 
together in a phial, two spoonsful of salad-oil, with 
one of spirits of hartshorn. To a table spoonful of 
this may be added a tea-spoonful of laudanum; to rub 
the stomach in obstinate vomiting. 

JEther should be preserved in the same manner as 
the foregoing, and care should be taken not to approach 

too near a Candle with either of these III 1 1 lids, especially 



350 APPENDIX. 

the latter, which is particularly inflammable. From 
two to ten drops may be given in some sort of convul- 
sive maladies, several times in the day. 

Tincture of assafietida.— A small quantity of 
this should be kept to give in clysters. From ten to 
thirty drops, according to the age of the child. 

Laudanum. — A small quantity of this should also 
be at hand, in case of being required for external appli- 
cation J or for clysters. 

Opodeldoc and vegeto-mineral water for bruises, 
and Ceruse to prepare ointment for burns, should be 
amongst the medicines kept for the use of children. 

The following are the best preparations of iron for 
children. Chalybeate wine, which may be given from 
five drops to twenty once a day, (in a spoonful of any 
convenient Liquid,)to those between the ages of eighteen 
months and ten years. The iron in substance, reduced 
to a powder as fine as magnesia, of which so much may 
be given as equals a pinch of snuff, in a spoonful of 
thick soup or bread and waterjust as the child is going 
to dinner, when it will have a better effect than if the 
stomach were to remain empty after it. The quantity 
must be a little more or less, according to the child's 
a<*e ; and no preparation of iron should be given till 
after children are weaned. The use of this medicine 
gives a black color to the evacuations from the bowels, 
which mothers ought to be aware of, to prevent their 
being alarmed. 

I have not mentioned any of the purging salts in this 
list of medicines, as children usually dislike them ex- 
tremely, and it is easy to procure them when ordered 



APPENDIX. 351 

by a physician. Common salt, in rather a less quantity 
than is usually given of Epsom salt, dissolved in a suf- 
ficient quantity of broth, to be swallowed without dis- 
gust, will not fail to purge mildly. 

In weighing medicines, it is always right to lay a 
piece of paper in the scales under them, as many im- 
bibe a degree of poison by coming in contact with 
brass ; and be the quantity ever so inconsiderable, it is 
better to be avoided. 

Clysters should generally be a little warmer than 
milk, just drawn from the cow. The quantity for in- 
fants under two months old, is from two ounces to two 
and a half: children of four or five years old may take 
three or four ounces; and those who are older, five or 
six. A common table-spoon contains about half an 
ounce, and for these purposes, very exact measure is 
unnecessary. Oil, coarse sugar, salt, or honey, are the 
proper ingredients to mix with water, for common 
clysters, intended only to empty the bowels ; but some 
children require them much stronger than others, and 
fbl these a double portion of the above mentioned sub- 
stances must he employed ; and sometimes castor-oil 
must be used instead of salad-oil. In general, three 
tea-spoonsful of oil may be put to every ounce of water : 
salt should he used more sparingly than the other ingre- 
dients. For the cbolic, oil may be mixed with a light 
infusion of chamomile Sowers ; and if the cholic pro- 
ceed from wind, three ounces of this infusion, and ten 
drops of tincture of assafcetida, is a proper clyster for a 
child of a year old. 

Baths for THE PEET of children should be some- 
what warmer than new milk. The mustard bath 
may be prepared with a table-spoonful of coarse mus- 
tard to every gallon of water; that of vinegar, with 



352 APPENDIX. 

rather less than half a pint to that quantity ; and when 
both mustard and vinegar are used, half the quantity 
of each will be sufficient. To make a salt-water 
bath, three or four spoonsful of kitchen salt to a gal- 
lon of water will probably be enough. The use of all 
these baths is to chaw the blood from the head and 
body to the feet, and they are often of the greatest 
advantage. 

Fomfntvtions, of the same ingredients, and for the 
same purpose, may be employed ; but the liquid must 
be much hotter: twenty minutes, or half an hour, will 
be sufficient fox fomenting the feet, and the flannels or 
clothes should be changed four or five times. 

There are many ways of preparing sinapisms ; but 
the Bimplest and surest is by mixing coarse mustard 
with good vinegar, in sufficient quantity to form a 
paste, and applying h in a piece of thin gauze, winch 
prevents unnecessary dirt and inconvenience. A si- 
napism cannot be kept long on the hollow part of the 
foot without causing great pain, which renders walk- 
in- disagreeable forsome time after : this may be avoid- 
ed by making them in two parts for the sole of each 
foot," and removing that next the hollow as soon as it 
gives pain, which will be some time before the front 
part of the foot is sufficintly affected. 

Gargles should be in general of an emollient 
nature, such as barley-water, decoction of marsh- 
mallows, honey and water, &c. ; but a few drops of 
vinegar, or a little red wine, may sometimes be added. 
When a sore-throat is bad enough to require more 
active gardes, the advice of a physician will be neces- 
sary ; and therefore it is unnecessary to give directions 
about them here. 



APPENDIX. 353 

To prepare the cream of tartar drink, recommended 
by an eminent medical author for bilious dysentery, 
half an ounce of this poAvder must be boiled with an 
ounce of barley, in rather more than a quart of water; 
and when the barley is as soft as in the usual way of 
making barley-water, it must be strained through a 
cloth, and sweetened or not, as may be agreeable to 
the taste of the sick child. This drink must be given 
from one to four ounces at a time, according to the age 
of the patient, very frequently, as it is intended to 
purge off the bile. It might be found useful as a mild 
purgative in other maladies also. 

Barley and rice-water, chicken-brotb, whey, almond- 
milk, &c. every one knows how to make ; and there- 
fore I shall give no directions about them here, but 
only recommend the greatest attention to cleanliness, 
as children have often refused drink, in diseases where 
it was of the greatest importance to them, in conse- 
quence of having been disgusted by some accidental 
nasty taste, occasioned by negligence. All these 
drinks should be made fresh, at least, once a day ; and 
such as have remained in a warm room all night, can 
scarcely be wholesome for a child in the morning, es- 
pecially as they soon turn sour in a hot atmosphere. 
In making broth for the sick, care should be taken to 
skin the chicken completely before it is put to boil ; 
and in making almond-milk, to watch that no part of 
it turn to oil. 

Lemon-peel should not be left to infuse in any sort 
of drink more than two or three hours, or it may give 
a disagreeable taste. Lemon-peel (as well as all sorts 
of herb) tea is to be made, by pouring on it boiling 
water, aud leaving it in a covered vessel by the fire 
for about twenty minutes. Ginger tea should not be 
made with the powder, but a piece of the root bruised 
22 



354 APPENDIX. 

with a hammer. All these infusions are better, when 
strained in a couple of hours after they are made. 

No sort of drink should be forced on a sick child, 
however wholesome it may be considered. When 
there is a dry, burning heat in the skin, every thing 
may be given cold ; and in many cases, good cold wa- 
ter, which instinct leads the patient to desire, is of 
great benefit. 

A good way to make jelly of Iceland lichen is, to 
wash an ounce of the herb well with tepid water on a 
sieve, and then to boil it very slowly in a quart of wa- 
ter, down to three quarters of a pint, and strain while 
it is hot. This may be given by ounces, three or four 
times a day, mixed with a sufficient quantity of lemon 
nr orange-juice and sugar, to make it palatable, to 
children who are weak, and have a cough after mea- 
zles, &c. &c. 

To prepare oat-jelly, (flummery,) take a quart of grits, 
rub them well with your hands in warm water, and 
leave them to steep for some days till they are quite 
sour ; then add about two quarts of hot water, and 
strain through a hair sieve. Let this stand till the wa- 
ter grows quite clear, and then pour it off gently; add 
to the sediment as much hot water as is necessary to 
make it boil, and stir it the whole time it is boiling. 
In short, it should be like starch ; and if it become too 
thick before it form a sort of jelly, boiling water must 
be added to it. The vessel in which Jlummery is made 
ought not to be of tin ; and a little butter must be first 
rubbed on the bottom of it. This jelly may be eaten 
with milk, wine, or sugar ; and being veiy easy of di- 
gestion, and extremely nourishing, is particularly good 
for convalescents when they happen to like it; I give 
the directions for making it here, because, though very 



appendix. 355 

common in some parts of the British islands, it is not 
known in others. 9 

N. B. All medicines should be kept under lock and 
key, and no persons be permitted to have access to 
them, but such as are well aware of the dangerous con- 
sequences of any mistake in their management or their 
administration. 



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